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General NPI Number Information
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NPI Number | 1760723688
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Entity Type | Organization
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Legal Business Name | ISSY DENTAL COMPANY
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Dates
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Enumeration Date | 03/04/2013
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Last Update Date | 03/04/2013
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Provider Practice Location Address
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Address Line | 8420 HIGHWAY 6 N
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City | HOUSTON
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State | TX
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Zip | 77095-2004
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Country | US
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Telephone | 832-413-2944
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 842156
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City | HOUSTON
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State | TX
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Zip | 77284-2156
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Country | US
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Telephone | 832-413-2944
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SON NGUYEN BUI
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Credential | D.M.D.
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Telephone | 832-413-2944
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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 | 23652
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License Number State | TX
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