MEDICARE: THN DENTAL 2023 PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1336859032
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THN DENTAL 2023 PLLC

Provider Business Mailing Address
First Line	:	2615 W PIONEER PKWY STE 120
Second Line	:
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75051-3617
Country	:	US
Telephone Number	:	972-352-2980
Fax Number	:

Provider Business Practice Location Address
First Line	:	2615 W PIONEER PKWY STE 120
Second Line	:
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75051-3617
Country	:	US
Telephone Number	:	972-352-2980
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	THIEN V NGUYEN
Credential	:	DDS
Telephone Number	:	714-352-9273

Provider Enumeration Date	:	12/02/2022
Last Update Date	:	12/02/2022

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