Provider Demographics
NPI:1457769622
Name:NORTH DALLAS DENTISTRY ASSOCIATES, PC
Entity Type:Organization
Organization Name:NORTH DALLAS DENTISTRY ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AN
Authorized Official - Middle Name:QUOC
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:214-348-2320
Mailing Address - Street 1:4637 HEDGCOXE RD
Mailing Address - Street 2:SUITE 112
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-3962
Mailing Address - Country:US
Mailing Address - Phone:972-377-8866
Mailing Address - Fax:972-377-8870
Practice Address - Street 1:8535 FERNDALE RD
Practice Address - Street 2:SUITE 14
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75238-4425
Practice Address - Country:US
Practice Address - Phone:214-348-2320
Practice Address - Fax:972-235-4491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-31
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX222041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty