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Organization
TY DENTAL HALTOM CITY PLLC
Active
Organization
TY DENTAL HALTOM CITY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIEN PHAN DMD (OWNER)
(408) 835-3726
Entity
Organization
Contact information
Practice address
3101 DENTON HWY STE 100, HALTOM CITY, TX 76117-3706
(817) 831-6500
Mailing address
8150 SPRINGWOOD DR STE 150B, IRVING, TX 75063-5810
(956) 507-7253
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0106X
Oral and Maxillofacial Pathology Dentistry
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
Other
Enumeration date
12/22/2025
Last updated
12/22/2025
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