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General NPI Number Information
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NPI Number | 1336692995
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Entity Type | Organization
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Legal Business Name | SUNLIGHT DENTAL GROUP PA
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Dates
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Enumeration Date | 08/01/2016
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Last Update Date | 08/01/2016
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Provider Practice Location Address
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Address Line | 1816 PEARLAND PKWY # 190
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City | PEARLAND
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State | TX
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Zip | 77581-5100
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Country | US
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Telephone | 832-243-1740
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Fax | 832-288-4502
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Provider Business Mailing Address
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Address Line | 1816 PEARLAND PKWY # 190
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City | PEARLAND
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State | TX
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Zip | 77581-5100
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Country | US
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Telephone | 832-243-1740
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Fax | 832-288-4502
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Authorized Official
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Title or Position | DIRECTOR/OWNER
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Name | DR. VINCE BA NGUYEN
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Credential | DMD
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Telephone | 832-243-1740
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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 | 25274
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License Number State | TX
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