Healthcare Provider Details

I. General information

NPI: 1295800704
Provider Name (Legal Business Name): METRO DENTAL, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12790 VETERANS MEMORIAL DR
HOUSTON TX
77014-2048
US

IV. Provider business mailing address

12790 VETERANS MEMORIAL DR
HOUSTON TX
77014-2048
US

V. Phone/Fax

Practice location:
  • Phone: 281-580-7620
  • Fax:
Mailing address:
  • Phone: 281-580-7620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number19643
License Number StateTX

VIII. Authorized Official

Name: DR. CHRISTINA HAI VU
Title or Position: VICE PRESIDENT
Credential: D.D.S.
Phone: 281-580-7620