Provider Demographics
NPI:1760723688
Name:ISSY DENTAL COMPANY
Entity Type:Organization
Organization Name:ISSY DENTAL COMPANY
Other - Org Name:ISSY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SON
Authorized Official - Middle Name:NGUYEN
Authorized Official - Last Name:BUI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:832-413-2944
Mailing Address - Street 1:PO BOX 842156
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77284-2156
Mailing Address - Country:US
Mailing Address - Phone:832-413-2944
Mailing Address - Fax:
Practice Address - Street 1:8420 HIGHWAY 6 N
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-2004
Practice Address - Country:US
Practice Address - Phone:832-413-2944
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-04
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23652122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty