Provider Demographics
NPI:1265890503
Name:VL DENTAL, PLLC
Entity type:Organization
Organization Name:VL DENTAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HOA
Authorized Official - Middle Name:
Authorized Official - Last Name:VONGSENGDEUANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-239-7200
Mailing Address - Street 1:825 PLANTATION DR STE 140
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-8001
Mailing Address - Country:US
Mailing Address - Phone:281-239-7200
Mailing Address - Fax:
Practice Address - Street 1:825 PLANTATION DR STE 140
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-8001
Practice Address - Country:US
Practice Address - Phone:281-239-7200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-01
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty