Provider Demographics
NPI:1871868836
Name:TRUC NHA DINH DDS, PLLC
Entity type:Organization
Organization Name:TRUC NHA DINH DDS, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TRUC
Authorized Official - Middle Name:NHA
Authorized Official - Last Name:DINH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:936-856-3900
Mailing Address - Street 1:12501 CANYON FALLS BLVD STE F
Mailing Address - Street 2:
Mailing Address - City:WILLIS
Mailing Address - State:TX
Mailing Address - Zip Code:77318-5739
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12501 CANYON FALLS BLVD STE F
Practice Address - Street 2:
Practice Address - City:WILLIS
Practice Address - State:TX
Practice Address - Zip Code:77318-5739
Practice Address - Country:US
Practice Address - Phone:936-856-3900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-09
Last Update Date:2012-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX245961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty