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General NPI Number Information
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NPI Number | 1568582674
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Entity Type | Organization
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Legal Business Name | A & A DENTAL ENTERPRISE, P.A.
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Dates
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Enumeration Date | 03/30/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2596 E ARKANSAS LN SUITE 156
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City | ARLINGTON
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State | TX
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Zip | 76014-1764
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Country | US
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Telephone | 817-276-8500
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Fax |
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Provider Business Mailing Address
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Address Line | 2596 E ARKANSAS LN SUITE 156
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City | ARLINGTON
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State | TX
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Zip | 76014-1764
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Country | US
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Telephone | 817-276-8500
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. ANDREW H PHAN
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Credential | D.D.S.
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Telephone | 817-276-8500
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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 |
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License Number State |
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