# IRVING TOWN CENTER DENTAL

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

## Provider details

- **NPI number:** 1376814103
- **Authorized official:** MARY PU (VP OF FINANCE)
- **Authorized official phone:** (972) 869-3789

## Contact information

- **Practice address:** 7301 STATE HIGHWAY 161 STE 198, IRVING, TX 75039-2880
- **Practice address phone:** (972) 869-3789
- **Mailing address:** 7301 STATE HIGHWAY 161 STE 198, IRVING, TX 75039-2880
- **Mailing address phone:** (972) 869-3789
- **Mailing address fax:** (972) 869-3791

## Taxonomy

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

## Other

- **Enumeration date:** 01/25/2012
- **Last updated:** 01/25/2012