Provider Demographics
NPI:1396274080
Name:DULCE DENTAL PLLC
Entity type:Organization
Organization Name:DULCE DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:KUAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-324-4152
Mailing Address - Street 1:2906 E BERRY ST
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76105-4755
Mailing Address - Country:US
Mailing Address - Phone:817-289-5200
Mailing Address - Fax:
Practice Address - Street 1:3225 FORT WORTH AVE STE 100
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75211-2421
Practice Address - Country:US
Practice Address - Phone:817-289-5200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-07
Last Update Date:2017-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty