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1100 W Pioneer Dr Irving TX 75061-7213 | |
| (972) 870-5282 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1100 W Pioneer Dr, Irving, Texas |
| Authorized Official Name and Position | Hieu Tan Phan (PRESIDENT) |
| Authorized Official Contact | 9728705282 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1100 W Pioneer Dr Irving TX 75061-7213 Ph: (972) 870-5282 | 1100 W Pioneer Dr Irving TX 75061-7213 Ph: (972) 870-5282 |
| NPI Number | 1043540305 |
|---|---|
| Provider Enumeration Date | 01/10/2010 |
| Last Update Date | 07/19/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043540305 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 23356 (Texas) | Primary |
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