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General NPI Number Information
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NPI Number | 1457953903
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Entity Type | Organization
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Legal Business Name | TAKII FAMILY DENTISTRY PLLC
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Dates
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Enumeration Date | 11/10/2020
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Last Update Date | 11/10/2020
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Provider Practice Location Address
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Address Line | 3200 N MAIN ST STE 117
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City | TAYLOR
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State | TX
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Zip | 76574-1216
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Country | US
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Telephone | 737-235-1201
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Fax |
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Provider Business Mailing Address
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Address Line | 121 VULCAN DR
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City | JARRELL
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State | TX
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Zip | 76537-4436
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Country | US
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Telephone | 737-235-1201
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Fax |
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. ISAO FRANCISCO TAKII
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Credential | DDS
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Telephone | 737-235-1201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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