Provider Demographics
NPI:1750899688
Name:DENTAL FOREST PLLC
Entity type:Organization
Organization Name:DENTAL FOREST PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DONG
Authorized Official - Middle Name:HYUN
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-382-2900
Mailing Address - Street 1:1060 S. PRESTON RD. #110
Mailing Address - Street 2:
Mailing Address - City:CELINA
Mailing Address - State:TX
Mailing Address - Zip Code:75009
Mailing Address - Country:US
Mailing Address - Phone:972-382-2900
Mailing Address - Fax:972-736-4717
Practice Address - Street 1:1060 S. PRESTON RD. #110
Practice Address - Street 2:
Practice Address - City:CELINA
Practice Address - State:TX
Practice Address - Zip Code:75009
Practice Address - Country:US
Practice Address - Phone:972-382-2900
Practice Address - Fax:972-736-4717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-12
Last Update Date:2018-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty