Provider Demographics
NPI:1366990137
Name:PHEE DENTAL GROUP
Entity type:Organization
Organization Name:PHEE DENTAL GROUP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONG
Authorized Official - Middle Name:HOON
Authorized Official - Last Name:PHEE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:940-566-1066
Mailing Address - Street 1:4920 TEASLEY LN
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210
Mailing Address - Country:US
Mailing Address - Phone:940-566-1066
Mailing Address - Fax:940-566-1033
Practice Address - Street 1:4920 TEASLEY LN
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210
Practice Address - Country:US
Practice Address - Phone:940-566-1066
Practice Address - Fax:940-566-1033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-21
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX239691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1841453222OtherNPI TYPE 1