Provider Demographics
NPI:1649706961
Name:ABBIE ANNA DENTAL, PLLC
Entity type:Organization
Organization Name:ABBIE ANNA DENTAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HANAH
Authorized Official - Middle Name:H
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-820-6050
Mailing Address - Street 1:3628 FRANKFORD RD STE 235
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75287-6165
Mailing Address - Country:US
Mailing Address - Phone:972-820-6050
Mailing Address - Fax:972-820-5709
Practice Address - Street 1:3628 FRANKFORD RD STE 235
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75287-6165
Practice Address - Country:US
Practice Address - Phone:972-820-6050
Practice Address - Fax:972-820-5709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-05
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19762122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty