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General NPI Number Information
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NPI Number | 1336254325
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Entity Type | Organization
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Legal Business Name | EXCEL DENTAL CLINIC OF GARLAND PA
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Dates
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Enumeration Date | 08/20/2006
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Last Update Date | 10/21/2022
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Provider Practice Location Address
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Address Line | 1815 S 1ST ST STE H
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City | GARLAND
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State | TX
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Zip | 75040-8441
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Country | US
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Telephone | 972-271-4500
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Fax | 972-271-4511
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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
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Country | US
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Telephone | 972-231-6382
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Fax | 972-271-4511
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Authorized Official
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Title or Position | MANAGING DENTIST
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Name | DR. QUYEN TU HUYNH
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Credential | DDS
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Telephone | 214-375-9999
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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 | 19841
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License Number State | TX
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Taxonomy #2
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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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Taxonomy #3
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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 #4
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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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