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General NPI Number Information
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NPI Number | 1942914965
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Entity Type | Organization
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Legal Business Name | MILLENNIAL MONARCH CLUB PLLC
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Dates
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Enumeration Date | 01/13/2023
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Last Update Date | 01/13/2023
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Provider Practice Location Address
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Address Line | 15720 WOODLAND HILLS DR. SUITE 900
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City | HUMBLE
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State | TX
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Zip | 77396
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Country | US
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Telephone | 281-713-5156
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Fax | 281-713-5602
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Provider Business Mailing Address
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Address Line | 15720 WOODLAND HILLS DR. SUITE 900
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City | HUMBLE
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State | TX
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Zip | 77396
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Country | US
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Telephone | 281-713-5156
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Fax | 281-713-5602
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Authorized Official
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Title or Position | CEO
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Name | DR. TU M DOAN
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Credential | DDS
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Telephone | 469-684-9105
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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