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Organization
ISMILE DENTAL AT LA GRAN PLAZA, PLLC
Active
Organization
ISMILE DENTAL AT LA GRAN PLAZA, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THANH TRUONG DDS (PRESIDENT)
(817) 924-8000
Entity
Organization
Contact information
Practice address
4200 SOUTH FWY, SUITE 1550, FORT WORTH, TX 76115-1400
(817) 924-8000
Mailing address
PO BOX 16249, FORT WORTH, TX 76162-0249
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22611
TX
Other
Enumeration date
09/27/2012
Last updated
09/27/2012
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