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General NPI Number Information
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NPI Number | 1952032617
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Entity Type | Organization
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Legal Business Name | TEXAS DENTAL SPA PLLC
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Dates
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Enumeration Date | 06/22/2022
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Last Update Date | 06/22/2022
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Provider Practice Location Address
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Address Line | 2995 PRESTON RD STE 1500
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City | FRISCO
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State | TX
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Zip | 75034-0602
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Country | US
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Telephone | 972-242-2155
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Fax |
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Provider Business Mailing Address
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Address Line | 1809 GOLDEN TRAIL CT STE 140
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City | CARROLLTON
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State | TX
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Zip | 75010-4667
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Country | US
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Telephone | 972-242-2155
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. LINH K NGUYEN
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Credential | DDS
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Telephone | 972-242-2155
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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