Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 22982 | TX |
NPI | 1003979857 |
---|---|
Provider Name | Duc H Doan |
First Address | Dallas, TX 75241-2008 |
Second Address | Dallas, TX 75241-2008 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2006 |
Last Update Date | 08/07/2007 |