Provider Demographics
NPI:1144687450
Name:ADVANCED CARE DENTURES AND DENTISTRY
Entity type:Organization
Organization Name:ADVANCED CARE DENTURES AND DENTISTRY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOANG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-997-1703
Mailing Address - Street 1:3320 BROADWAY ST
Mailing Address - Street 2:STE. 110
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-4376
Mailing Address - Country:US
Mailing Address - Phone:281-997-1703
Mailing Address - Fax:281-997-1716
Practice Address - Street 1:3320 BROADWAY ST
Practice Address - Street 2:STE. 110
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-4376
Practice Address - Country:US
Practice Address - Phone:281-997-1703
Practice Address - Fax:281-997-1716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-19
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX277561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty