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General NPI Number Information
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NPI Number | 1558761742
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Entity Type | Organization
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Legal Business Name | DALLAS DENTISTRY ASSOCIATES, P.C.
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Dates
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Enumeration Date | 08/26/2014
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Last Update Date | 08/26/2014
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Provider Practice Location Address
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Address Line | 4709 W PARKER RD STE 550
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City | PLANO
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State | TX
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Zip | 75093-3367
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Country | US
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Telephone | 469-467-6162
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Fax | 469-467-8585
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Provider Business Mailing Address
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Address Line | 4637 HEDGCOXE RD STE 112
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City | PLANO
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State | TX
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Zip | 75024-3963
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Country | US
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Telephone | 469-467-6162
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Fax | 469-467-8585
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | AN QUOC LE
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Credential | D.D.S.
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Telephone | 469-467-6162
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 22204
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License Number State | TX
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