| Vanida Wongchukit Dds Pa | |
|
4727 Lexington Blvd Missouri City TX 77459-2825 | |
| (281) 403-3595 | |
| (281) 403-3709 |
| Full Name | Vanida Wongchukit Dds Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4727 Lexington Blvd, Missouri City, Texas |
| Authorized Official Name and Position | Vanida Wongchukit (PRESIDENT) |
| Authorized Official Contact | 2814033595 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vanida Wongchukit Dds Pa 4727 Lexington Blvd Missouri City TX 77459-2825 Ph: (281) 403-3595 | Vanida Wongchukit Dds Pa 4727 Lexington Blvd Missouri City TX 77459-2825 Ph: (281) 403-3595 |
| NPI Number | 1053568451 |
|---|---|
| Provider Enumeration Date | 08/27/2008 |
| Last Update Date | 08/27/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053568451 | NPI | - | NPPES |
| 183580301 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 20976 (Texas) | Primary |
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