Provider Demographics
NPI:1336783018
Name:LEVO DENTAL 2 PLLC
Entity Type:Organization
Organization Name:LEVO DENTAL 2 PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TUAN ANH
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-863-8559
Mailing Address - Street 1:621 HIDDEN CREEK WAY
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78626-2529
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3737 WILLIAMS DR
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78628-2401
Practice Address - Country:US
Practice Address - Phone:512-863-8559
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LEVO DENTAL 2 PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-11-05
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental