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General NPI Number Information
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NPI Number | 1417834086
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Entity Type | Organization
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Legal Business Name | DENTAL HEALTH ASSOCIATES OF TX, P.C.
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Dates
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Enumeration Date | 08/18/2025
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Last Update Date | 08/18/2025
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Provider Practice Location Address
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Address Line | 11930 US HIGHWAY 290 E UNIT 110
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City | MANOR
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State | TX
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Zip | 78653-3254
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Country | US
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Telephone | 512-402-5595
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Fax | 512-402-5578
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Provider Business Mailing Address
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Address Line | 11930 US HIGHWAY 290 E UNIT 110
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City | MANOR
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State | TX
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Zip | 78653-3254
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING COORDINATOR
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Name | HILLARY THULL
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Credential |
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Telephone | 217-540-8946
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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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