Healthcare Provider Details

I. General information

NPI: 1033963186
Provider Name (Legal Business Name): NGO & GARCES PEDIATRIC DENTISTRY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2024
Last Update Date: 04/15/2024
Certification Date: 04/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1222 N BISHOP AVE STE 500
DALLAS TX
75208-4178
US

IV. Provider business mailing address

423 W COLORADO BLVD
DALLAS TX
75208-2408
US

V. Phone/Fax

Practice location:
  • Phone: 214-833-8964
  • Fax:
Mailing address:
  • Phone: 832-512-1810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State

VIII. Authorized Official

Name: ANTHONY NGO
Title or Position: PARTNER
Credential: DDS
Phone: 832-512-1810