| Kudo Care Dental Pllc | |
|
3425 Grande Bulevar Irving TX 75062-5108 | |
| (972) 258-8354 | |
| Not Available |
| Full Name | Kudo Care Dental Pllc |
|---|---|
| Speciality | Dentist |
| Location | 3425 Grande Bulevar, Irving, Texas |
| Authorized Official Name and Position | Anh Quynh Nguyen (PRESIDENT) |
| Authorized Official Contact | 4692308066 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kudo Care Dental Pllc 3425 Grande Bulevar Irving TX 75062-5108 Ph: (972) 639-5836 | Kudo Care Dental Pllc 3425 Grande Bulevar Irving TX 75062-5108 Ph: (972) 258-8354 |
| NPI Number | 1811419070 |
|---|---|
| Provider Enumeration Date | 07/10/2017 |
| Last Update Date | 10/23/2019 |
| Medicare PECOS PAC ID | 0143563965 |
|---|---|
| Medicare Enrollment ID | O20190520000562 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811419070 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
| Provider Name | Anh Quynh Nguyen |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1134469877 PECOS PAC ID: 9739422551 Enrollment ID: I20190520000834 |
| Provider Name | An Tat Nguyen |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1164525192 PECOS PAC ID: 5698018414 Enrollment ID: I20190520001011 |
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