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Organization
PREMIER DENTIST GROUP, PA
Active
Organization
PREMIER DENTIST GROUP, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIM ANH THI NGUYEN DDS (DENTIST)
(713) 432-0900
Entity
Organization
Contact information
Practice address
5420 BELLAIRE BLVD BLDG 4, BELLAIRE, TX 77401-3957
(713) 432-0900
Mailing address
5420 BELLAIRE BLVD BLDG 4, BELLAIRE, TX 77401-3957
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G60196-02
CHIP
TX
Enumeration date
09/06/2007
Last updated
09/06/2007
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