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General NPI Number Information
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NPI Number | 1316257710
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Entity Type | Organization
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Legal Business Name | T-DENTAL,P.C
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Dates
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Enumeration Date | 10/19/2010
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Last Update Date | 10/19/2010
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Provider Practice Location Address
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Address Line | 9625 PLANO ROAD 100
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City | DALLAS
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State | TX
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Zip | 75238
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Country | US
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Telephone | 408-390-1384
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Fax |
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Provider Business Mailing Address
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Address Line | 9625 PLANO ROAD 100
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City | DALLAS
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State | TX
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Zip | 75238
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Country | US
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Telephone | 408-390-1384
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Fax |
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Authorized Official
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Title or Position | GENERAL DENTIST PROVIDER/PRESIDENT
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Name | MANH CHI TRUONG
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Credential | D.M.D
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Telephone | 408-390-1384
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 23516
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License Number State | TX
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