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NPI 1780300749

NPI 1780300749 : TUAN ANH LUONG DDS : CARROLLTON, TX

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General NPI Number Information
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    NPI Number           |    1780300749
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    Entity Type          |    Individual 
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    Provider Name        |    TUAN ANH LUONG DDS
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    10/12/2022
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    Last Update Date     |    10/19/2022
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Provider Practice Location Address
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    Address Line         |    1712 ALPINE DR 
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    City                 |    CARROLLTON
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    State                |    TX
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    Zip                  |    75007-3740
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    Country              |    US
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    Telephone            |    972-971-7079
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    Fax                  |    972-939-6627
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Provider Business Mailing Address
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    Address Line         |    1712 ALPINE DR 
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    City                 |    CARROLLTON
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    State                |    TX
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    Zip                  |    75007-3740
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    Country              |    US
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    Telephone            |    972-971-7079
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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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       |    108228
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    License Number State |    CA
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