Provider Demographics
NPI:1538823547
Name:THAT DANG TOOTH PLLC
Entity type:Organization
Organization Name:THAT DANG TOOTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:QUOC
Authorized Official - Middle Name:
Authorized Official - Last Name:DANG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:408-705-5001
Mailing Address - Street 1:3260 N ZARAGOZA RD STE D406
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79938-4677
Mailing Address - Country:US
Mailing Address - Phone:915-271-4777
Mailing Address - Fax:
Practice Address - Street 1:3260 N ZARAGOZA RD STE D406
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79938-4677
Practice Address - Country:US
Practice Address - Phone:915-271-4777
Practice Address - Fax:915-271-4774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-26
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Multi-Specialty