MEDICARE: TD DENTAL PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	1223G0001X	General Practice Dentistry
2	261QD0000X	Dental Clinic/Center
3	261QD0000X	Dental Clinic/Center	TX

General Provider Information

NPI Number	:	1972011690
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TD DENTAL PLLC

Provider Business Mailing Address
First Line	:	347 W JEFFERSON BLVD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75208-4602
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	347 W JEFFERSON BLVD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75208-4602
Country	:	US
Telephone Number	:	214-886-6875
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. NHU DANG
Credential	:	DDS
Telephone Number	:	214-886-6875

Provider Enumeration Date	:	01/16/2018
Last Update Date	:	01/25/2024

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Directions to “TD DENTAL PLLC ” Practice Location

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