Healthcare Provider Details
I. General information
NPI: 1396961207
Provider Name (Legal Business Name): HEALTH INNOVATIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/18/2007
Last Update Date: 04/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3211 W NORTHWEST HWY STE 100
DALLAS TX
75220-5944
US
IV. Provider business mailing address
508 W MCDERMOTT DR STE 100
ALLEN TX
75013-2777
US
V. Phone/Fax
- Phone: 214-351-0590
- Fax:
- Phone: 972-747-1400
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
SON
TRAN
Title or Position: PRESIDENT
Credential: D.D.S.
Phone: 972-747-1400