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Organization
MAGNOLIA DENTAL
Active
Organization
MAGNOLIA DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIN TRUONG TRAN D.D.S. (PRESIDENT)
(817) 292-6203
Entity
Organization
Contact information
Practice address
6758 MCCART AVE, FORT WORTH, TX 76133-6357
(817) 292-6203
(817) 292-6279
Mailing address
6758 MCCART AVE, FORT WORTH, TX 76133-6357
(817) 292-6203
(817) 292-6279
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19770
TX
Other
Enumeration date
05/16/2008
Last updated
05/16/2008
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