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General NPI Number Information
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NPI Number | 1871764332
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Entity Type | Organization
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Legal Business Name | SOUTHWEST DENTISTS
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Dates
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Enumeration Date | 03/12/2008
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Last Update Date | 03/12/2008
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Provider Practice Location Address
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Address Line | 8324 SOUTHWEST FWY
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City | HOUSTON
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State | TX
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Zip | 77074-1603
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Country | US
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Telephone | 713-772-3499
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Fax | 713-772-3959
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Provider Business Mailing Address
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Address Line | 8324 SOUTHWEST FWY
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City | HOUSTON
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State | TX
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Zip | 77074-1603
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Country | US
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Telephone | 713-772-3499
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Fax | 713-772-3959
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Authorized Official
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Title or Position | DENTIST
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Name | DR. KHANH NGOC NGUYEN
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Credential | D.D.S, PA
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Telephone | 713-772-3499
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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 | 17906
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License Number State | TX
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