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12804 Gulf Fwy Ste 400 Houston TX 77034-4813 | |
| (281) 481-2048 | |
| (281) 484-4193 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 12804 Gulf Fwy, Houston, Texas |
| Authorized Official Name and Position | Khanh Duy Nguyen (PRESIDENT) |
| Authorized Official Contact | 2814812048 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
12804 Gulf Fwy Ste 400 Houston TX 77034-4813 Ph: (281) 481-2048 | 12804 Gulf Fwy Ste 400 Houston TX 77034-4813 Ph: (281) 481-2048 |
| NPI Number | 1922003557 |
|---|---|
| Provider Enumeration Date | 06/20/2005 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922003557 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 19859 (Texas) | Primary |
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