Healthcare Provider Details
I. General information
NPI: 1932241486
Provider Name (Legal Business Name): LI-YING HUANG DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/13/2007
Last Update Date: 06/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
279 W MAIN ST STE 110
FRISCO TX
75034-4307
US
IV. Provider business mailing address
245 E. GRAUWYLER ROAD SUITE 109
IRVING TX
75061
US
V. Phone/Fax
- Phone: 469-633-9925
- Fax:
- Phone: 214-596-9477
- Fax: 214-596-9446
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | 21720 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: