Healthcare Provider Details
I. General information
NPI: 1992166326
Provider Name (Legal Business Name): THANH KIM HONG, DMD, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/12/2016
Last Update Date: 03/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2955 ELDORADO PKWY STE 110
FRISCO TX
75033-7200
US
IV. Provider business mailing address
2955 ELDORADO PKWY STE 110
FRISCO TX
75033-7200
US
V. Phone/Fax
- Phone: 469-294-4239
- Fax:
- Phone: 469-294-4239
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | 24298 |
| License Number State | TX |
VIII. Authorized Official
Name: DR.
THANH
K
HONG
Title or Position: DENTIST
Credential: DMD
Phone: 469-294-4239