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General NPI Number Information
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NPI Number | 1053180778
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Entity Type | Organization
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Legal Business Name | ELEGANT DENTAL RICHMOND, PLLC
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Dates
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Enumeration Date | 12/21/2023
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Last Update Date | 12/21/2023
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Provider Practice Location Address
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Address Line | 5614 W GRAND PKWY S STE 120
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City | RICHMOND
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State | TX
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Zip | 77406-5820
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Country | US
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Telephone | 918-280-8309
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Fax |
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Provider Business Mailing Address
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Address Line | 1023 WILLIAMS LAKE DR
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City | RICHMOND
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State | TX
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Zip | 77469-4295
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Country | US
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Telephone | 310-709-3734
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Fax |
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Authorized Official
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Title or Position | OWNER DENTIST
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Name | DR. MOIZ U HORANI
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Credential | DDS
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Telephone | 918-280-8309
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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