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Organization
LA COSTA OF BEAUMONT PA
Active
Organization
LA COSTA OF BEAUMONT PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIEN DINH PHAN DMD (DENTIST)
(409) 351-3122
Entity
Organization
Contact information
Practice address
3870 COLLEGE STREET, SUITE #200, BEAUMONT, TX 77701
(972) 514-1689
Mailing address
8150 SPRINGWOOD DR # 150B, IRVING, TX 75063-5810
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22334
TX
Other
Enumeration date
05/27/2016
Last updated
08/13/2025
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