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General NPI Number Information
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NPI Number | 1396065306
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Entity Type | Individual
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Provider Name | PUCHNAN OUNG D.D.S
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Gender | Female
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Dates
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Enumeration Date | 06/02/2010
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Last Update Date | 06/02/2010
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Provider Practice Location Address
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Address Line | 1417 N BELT LINE RD
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City | IRVING
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State | TX
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Zip | 75061-1501
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Country | US
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Telephone | 972-870-1200
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Fax |
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Provider Business Mailing Address
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Address Line | 4122 TRAVIS ST UNIT 13
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City | DALLAS
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State | TX
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Zip | 75204-1856
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Country | US
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Telephone | 214-417-5450
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 25401
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License Number State | TX
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