Organization
DAZZLE DENTAL CARE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHNIE M NGUYEN DDS (PRESIDENT/ DENTIST)
(972) 355-8568
Entity
Organization
Contact information
Practice address
1121 FLOWER MOUND RD, SUITE 500, FLOWER MOUND, TX 75028-3504
(972) 355-8568
Mailing address
1121 FLOWER MOUND RD, SUITE 500, FLOWER MOUND, TX 75028-3504
(972) 355-8568
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22585
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201339301
—
TX
Enumeration date
06/05/2008
Last updated
04/25/2011
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