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General NPI Number Information
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NPI Number | 1306321260
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Entity Type | Organization
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Legal Business Name | RIDGE COMMONS FAMILY DENTISTRY PLLC
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Dates
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Enumeration Date | 09/26/2018
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Last Update Date | 09/26/2018
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Provider Practice Location Address
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Address Line | 4100 S RIDGE RD SUITE 103
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City | MCKINNEY
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State | TX
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Zip | 75070-0000
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Country | US
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Telephone | 469-688-6112
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Fax |
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Provider Business Mailing Address
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Address Line | 3000 MARGOT CT
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City | WYLIE
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State | TX
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Zip | 75098-8745
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Country | US
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Telephone | 469-684-4025
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Fax |
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | MS. VY NGUYEN
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Credential |
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Telephone | 469-688-6112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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