Organization
CANYON LAKE DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DHAVAL THAKKAR (DENTIST/ OWNER)
(903) 360-8657
Entity
Organization
Contact information
Practice address
8565 FM 2673, CANYON LAKE, TX 78133-4908
(903) 360-8657
Mailing address
9900 WESTPARK DR STE 350, HOUSTON, TX 77063-5285
(903) 360-8657
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/03/2020
Last updated
03/03/2020
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