Provider Demographics
NPI:1932358108
Name:THE DENTAL PLACE
Entity Type:Organization
Organization Name:THE DENTAL PLACE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NYCKI
Authorized Official - Middle Name:
Authorized Official - Last Name:HO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:214-477-6464
Mailing Address - Street 1:410 N HIGHWAY 175
Mailing Address - Street 2:208
Mailing Address - City:SEAGOVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75159-1837
Mailing Address - Country:US
Mailing Address - Phone:972-287-1544
Mailing Address - Fax:972-287-1243
Practice Address - Street 1:410 N HIGHWAY 175
Practice Address - Street 2:208
Practice Address - City:SEAGOVILLE
Practice Address - State:TX
Practice Address - Zip Code:75159-1837
Practice Address - Country:US
Practice Address - Phone:972-287-1544
Practice Address - Fax:972-287-1243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-12
Last Update Date:2008-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23269122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty