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General NPI Number Information
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NPI Number | 1649670357
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Entity Type | Organization
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Legal Business Name | STAFFORD DENTISTS PA
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Dates
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Enumeration Date | 08/29/2014
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Last Update Date | 01/15/2025
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Provider Practice Location Address
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Address Line | 11615 SOUTHWEST FWY
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City | HOUSTON
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State | TX
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Zip | 77031
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Country | US
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Telephone | 281-564-0117
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Fax | 281-564-0132
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Provider Business Mailing Address
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Address Line | 11615 SOUTHWEST FWY
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City | HOUSTON
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State | TX
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Zip | 77031
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Country | US
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Telephone | 281-564-0117
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Fax | 281-564-0132
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Authorized Official
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Title or Position | CEO
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Name | MRS. MINHLY DUY NGUYEN
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Credential | DDS
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Telephone | 281-564-0117
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1223D0004X
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Taxonomy Name | Dental Anesthesiology
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License Number |
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License Number State |
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