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Organization
FIFTH DENTAL PARTNER PLLC
Active
Organization
FIFTH DENTAL PARTNER PLLC
Active
Other names
Tesla Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
ANDY CHANG DDS (OWNER)
(972) 360-0805
Entity
Organization
Contact information
Practice address
2831 W 15TH ST STE 200, PLANO, TX 75075-7527
(972) 360-0805
Mailing address
2831 W 15TH ST STE 100, PLANO, TX 75075-7527
(469) 208-9800
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104040740
—
TX
Enumeration date
10/18/2019
Last updated
12/18/2020
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