| Organization Name: | DAISY DENTAL P.C. |
| NPI Number: | 1104117241 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOHNIE M NGUYEN (DENTIST/PRESIDENT) |
| Mailing Address: | 3970 Fm 2181 Suite 200 Hickory Creek |
| State: | TX US |
| Postal Code: | 750654249 |
| Phone Number: | 9729993580 |
| Fax Number: | |
| NPI Enumeration Date: | 04/24/2011 |
| NPI Last Update Date: | 07/16/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | 22585 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |