# ACCESS DENTAL OF FREDERICKSBURG PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093262172
- **Authorized official:** TIEN DINH PHAN DMD (CEO)
- **Authorized official phone:** (972) 514-1672

## Contact information

- **Practice address:** 4315 FREDERICKSBURG BALCONES HEIGHT, 100A, SAN ANTONIO, TX 78201
- **Practice address phone:** (972) 514-1672
- **Mailing address:** 1200 W WALNUT HILL LN, 3950, IRVING, TX 75038-3029
- **Mailing address phone:** (972) 514-1672

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 22334 | TX | Yes |

## Other

- **Enumeration date:** 09/06/2016
- **Last updated:** 09/06/2016