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General NPI Number Information
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NPI Number | 1760077226
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Entity Type | Organization
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Legal Business Name | LT DENTISTRY, PLLC
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Dates
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Enumeration Date | 03/06/2021
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Last Update Date | 03/06/2021
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Provider Practice Location Address
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Address Line | 18502 W BELLFORT ST STE 112
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City | RICHMOND
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State | TX
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Zip | 77407-9003
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Country | US
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Telephone | 832-378-7870
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Fax |
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Provider Business Mailing Address
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Address Line | 16807 KEPPIE WAY
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City | RICHMOND
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State | TX
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Zip | 77407-1516
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Country | US
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Telephone | 504-812-9488
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | DR. TOAN CHI VAN
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Credential | DDS
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Telephone | 504-812-9488
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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