Provider Demographics
NPI:1124318431
Name:HARKER HEIGHTS ROYAL DENTAL CENTER, PLLC
Entity type:Organization
Organization Name:HARKER HEIGHTS ROYAL DENTAL CENTER, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:SURENDRA
Authorized Official - Middle Name:B
Authorized Official - Last Name:RAJBHANDARI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:402-575-8404
Mailing Address - Street 1:480 E FM 2410 RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HARKER HEIGHTS
Mailing Address - State:TX
Mailing Address - Zip Code:76548-5721
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:480 E FM 2410 RD
Practice Address - Street 2:SUITE 200
Practice Address - City:HARKER HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:76548-5721
Practice Address - Country:US
Practice Address - Phone:402-575-8404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-08
Last Update Date:2011-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX26113261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental