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General NPI Number Information
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NPI Number | 1043531841
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Entity Type | Organization
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Legal Business Name | EXCEL DENTAL CLINIC OF LANCASTER, PC
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Dates
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Enumeration Date | 06/15/2010
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Last Update Date | 10/21/2022
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Provider Practice Location Address
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Address Line | 3200 S LANCASTER RD STE 183
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City | DALLAS
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State | TX
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Zip | 75216-4555
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Country | US
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Telephone | 214-375-9999
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Fax | 214-375-9997
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Provider Business Mailing Address
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Address Line | 4709 RAVENDALE DR
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City | RICHARDSON
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State | TX
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Zip | 75082-3838
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Country | US
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Telephone | 469-655-5221
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Fax | 214-375-9997
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. QUYEN TU HUYNH
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Credential | DDS
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Telephone | 469-655-9941
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 24546
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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