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General NPI Number Information
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NPI Number | 1285906487
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Entity Type | Organization
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Legal Business Name | 1ST CARE DENTAL, P.A.
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Dates
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Enumeration Date | 02/02/2012
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Last Update Date | 11/27/2012
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Provider Practice Location Address
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Address Line | 29110 HIGHWAY 290 SUITE 200
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City | CYPRESS
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State | TX
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Zip | 77433-4681
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Country | US
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Telephone | 281-256-7331
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Fax |
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Provider Business Mailing Address
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Address Line | 29110 HIGHWAY 290 SUITE 200
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City | CYPRESS
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State | TX
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Zip | 77433-4681
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Country | US
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Telephone | 281-256-7331
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PHUONGHANH HOANG
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Credential | DDS
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Telephone | 281-256-7331
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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 | 24744
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License Number State | TX
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