MEDICARE: ALPHA DENTIST, P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry		TX

General Provider Information

NPI Number	:	1245413970
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALPHA DENTIST, P.A.

Provider Business Mailing Address
First Line	:	2681 WILCREST DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77042-3211
Country	:	US
Telephone Number	:	713-787-5434
Fax Number	:

Provider Business Practice Location Address
First Line	:	2681 WILCREST DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77042-3211
Country	:	US
Telephone Number	:	713-787-5434
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. BICHNGOC NGUYEN
Credential	:
Telephone Number	:	713-787-5434

Provider Enumeration Date	:	12/17/2007
Last Update Date	:	12/17/2007

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Directions to “ALPHA DENTIST, P.A. ” Practice Location

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