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General NPI Number Information
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NPI Number | 1407113764
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Entity Type | Organization
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Legal Business Name | RICHARDSON DENTAL CARE
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Dates
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Enumeration Date | 04/11/2012
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Last Update Date | 04/11/2012
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Provider Practice Location Address
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Address Line | 9788 WALNUT ST STE 100
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City | DALLAS
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State | TX
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Zip | 75243-4842
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Country | US
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Telephone | 617-717-4158
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Fax |
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Provider Business Mailing Address
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Address Line | 9788 WALNUT ST STE 100
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City | DALLAS
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State | TX
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Zip | 75243-4842
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Country | US
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Telephone | 617-717-4158
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. KEVIN DUC NGUYEN
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Credential | D.D.S
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Telephone | 617-717-4158
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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 |
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License Number State |
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