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2596 E Arkansas Ln Suite 156 Arlington TX 76014-1764 | |
| (817) 276-8500 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2596 E Arkansas Ln, Arlington, Texas |
| Authorized Official Name and Position | Andrew H Phan (CEO) |
| Authorized Official Contact | 8172768500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2596 E Arkansas Ln Suite 156 Arlington TX 76014-1764 Ph: (817) 276-8500 | 2596 E Arkansas Ln Suite 156 Arlington TX 76014-1764 Ph: (817) 276-8500 |
| NPI Number | 1568582674 |
|---|---|
| Provider Enumeration Date | 03/30/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568582674 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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