Provider Demographics
NPI:1982884813
Name:S AND C DENTAL
Entity Type:Organization
Organization Name:S AND C DENTAL
Other - Org Name:GRANT FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:TAN
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-370-7778
Mailing Address - Street 1:12215 GRANT RD
Mailing Address - Street 2:SUITE #A
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-5962
Mailing Address - Country:US
Mailing Address - Phone:281-370-7778
Mailing Address - Fax:
Practice Address - Street 1:12215 GRANT RD
Practice Address - Street 2:SUITE #A
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-5962
Practice Address - Country:US
Practice Address - Phone:281-370-7778
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-08
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX213361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty