| NPI | 1821446055 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIEN DINH PHAN Dentist 972-514-1689 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 22334) |
| Enumeration Date | 2016-05-27 |
| Last Update Date | 2021-10-25 |