Organization Name: | DQ DENTAL SERVICES |
NPI Number: | 1306200050 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | QUYNH LE (PRESIDENT) |
Mailing Address: | 208 Main St Hutto |
State: | TX US |
Postal Code: | 786344524 |
Phone Number: | 5126424106 |
Fax Number: | 5124103015 |
NPI Enumeration Date: | 04/08/2016 |
NPI Last Update Date: | 04/08/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QD0000X |
License Number: | 23531 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Dental |
Taxonomy Definition: |