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General NPI Number Information
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NPI Number | 1609017052
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Entity Type | Organization
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Legal Business Name | SPARKLE DENTAL CENTER ASSOCIATES PC
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Dates
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Enumeration Date | 03/16/2009
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Last Update Date | 03/16/2009
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Provider Practice Location Address
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Address Line | 9205 SKILLMAN ST STE 128
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City | DALLAS
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State | TX
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Zip | 75243-9031
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Country | US
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Telephone | 469-360-8036
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Fax | 972-840-6830
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Provider Business Mailing Address
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Address Line | 9205 SKILLMAN ST STE 128
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City | DALLAS
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State | TX
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Zip | 75243-9031
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Country | US
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Telephone | 469-360-8036
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Fax | 972-840-6830
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. TUAN NGUYEN
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Credential | DDS
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Telephone | 469-360-8036
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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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