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Organization
MICHAEL W FUQUA DDS
Active
Organization
MICHAEL W FUQUA DDS
Active
Other names
Advanced Dental Associates
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL W FUQUA DDS (OWNER)
(956) 425-7474
Entity
Organization
Contact information
Practice address
713 S TEXAS, WESLACO, TX 78596
(956) 969-2960
(956) 969-3241
Mailing address
713 S TEXAS, WESLACO, TX 78596
(956) 969-2960
(956) 969-3241
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
16265
TX
1223G0001X
General Practice Dentistry
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120848004
—
TX
01
—
16265-02
TEXAS CHIPS
TX
Enumeration date
10/16/2006
Last updated
07/29/2008
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