MEDICARE: FRIEND-LY DENTISTS, PLLC

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

General Provider Information

NPI Number	:	1811334766
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRIEND-LY DENTISTS, PLLC

Provider Business Mailing Address
First Line	:	5677 TREASCHWIG RD
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77373-7162
Country	:	US
Telephone Number	:	281-645-4205
Fax Number	:	281-645-4565

Provider Business Practice Location Address
First Line	:	5677 TREASCHWIG RD
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77373-7162
Country	:	US
Telephone Number	:	281-645-4205
Fax Number	:	281-645-4565

Authorized Official
Title or Position	:	CEO
Name	:	DR. DUY TRI LY
Credential	:	DDS
Telephone Number	:	281-645-4205

Provider Enumeration Date	:	06/02/2013
Last Update Date	:	11/01/2018

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