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General NPI Number Information
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NPI Number | 1568614287
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Entity Type | Organization
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Legal Business Name | COLUMBIA DENTAL, P.A.
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Dates
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Enumeration Date | 10/13/2008
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Last Update Date | 10/13/2008
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Provider Practice Location Address
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Address Line | 4611 COLUMBIA AVE STE 104
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City | DALLAS
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State | TX
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Zip | 75226-2304
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Country | US
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Telephone | 214-827-8000
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Fax | 214-827-8001
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Provider Business Mailing Address
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Address Line | 4611 COLUMBIA AVE STE 104
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City | DALLAS
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State | TX
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Zip | 75226-2304
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NA TRAN
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Credential |
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Telephone | 214-827-8000
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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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