Provider Demographics
NPI:1831697408
Name:SUZUKI ORAL HEALTHCARE, PLLC
Entity type:Organization
Organization Name:SUZUKI ORAL HEALTHCARE, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TAKAHIRO
Authorized Official - Middle Name:
Authorized Official - Last Name:SUZUKI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:469-814-8211
Mailing Address - Street 1:2120 HEDGCOXE RD STE 150
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-3145
Mailing Address - Country:US
Mailing Address - Phone:469-814-8211
Mailing Address - Fax:
Practice Address - Street 1:2120 HEDGCOXE RD STE 150
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75025-3145
Practice Address - Country:US
Practice Address - Phone:469-814-8211
Practice Address - Fax:469-814-8028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-29
Last Update Date:2018-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31459261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental