| Dynasty Dental | |
|
717 S Greenville Ave #114 Allen TX 75002-3317 | |
| (214) 547-8628 | |
| (214) 547-8675 |
| Full Name | Dynasty Dental |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 717 S Greenville Ave, Allen, Texas |
| Authorized Official Name and Position | Janet Diem Tran (PRESIDENT) |
| Authorized Official Contact | 2145478628 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dynasty Dental 717 S Greenville Ave #114 Allen TX 75002-3317 Ph: (214) 547-8628 | Dynasty Dental 717 S Greenville Ave #114 Allen TX 75002-3317 Ph: (214) 547-8628 |
| NPI Number | 1336425651 |
|---|---|
| Provider Enumeration Date | 11/01/2011 |
| Last Update Date | 11/01/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336425651 | NPI | - | NPPES |
| 148653204 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 20556 (Texas) | Primary |
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