MEDICARE: MACARTHUR DENTAL P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	21305	TX

General Provider Information

NPI Number	:	1679782445
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MACARTHUR DENTAL P.A.

Provider Business Mailing Address
First Line	:	3204 N MACARTHUR BLVD SUITE # C
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75062
Country	:	US
Telephone Number	:	972-871-7681
Fax Number	:

Provider Business Practice Location Address
First Line	:	3204 N MACARTHUR BLVD STE C
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75062-8804
Country	:	US
Telephone Number	:	972-871-7681
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	DUSTY A A NGUYEN
Credential	:
Telephone Number	:	972-871-7681

Provider Enumeration Date	:	05/21/2007
Last Update Date	:	08/22/2020

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