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Organization
LA COSTA DENTAL OF LEOPARD PA
Active
Organization
LA COSTA DENTAL OF LEOPARD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIEN DINH PHAN DMD (DENTIST)
(817) 531-3500
Entity
Organization
Contact information
Practice address
3505 LEOPARD ST, CORPUS CHRISTI, TX 78408-3203
(817) 531-3500
(817) 531-3501
Mailing address
8150 SPRINGWOOD DR # 150B, IRVING, TX 75063-5810
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22334
TX
Other
Enumeration date
04/02/2014
Last updated
10/25/2021
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