| Daisy Dental P.c. | |
|
3970 Fm 2181 Suite 200 Hickory Creek TX 75065-4249 | |
| (972) 999-3580 | |
| Not Available |
| Full Name | Daisy Dental P.c. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 3970 Fm 2181, Hickory Creek, Texas |
| Authorized Official Name and Position | Johnie M Nguyen (DENTIST/PRESIDENT) |
| Authorized Official Contact | 9404976453 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Daisy Dental P.c. 3970 Fm 2181 Suite 200 Hickory Creek TX 75065-4249 Ph: (940) 497-6453 | Daisy Dental P.c. 3970 Fm 2181 Suite 200 Hickory Creek TX 75065-4249 Ph: (972) 999-3580 |
| NPI Number | 1104117241 |
|---|---|
| Provider Enumeration Date | 04/24/2011 |
| Last Update Date | 07/16/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104117241 | NPI | - | NPPES |
| 1900193-03 | Other | TX | MEDICAID PROVIDER |
| 2208027-01 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 22585 (Texas) | Primary |
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