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Organization
TPHAN DENTAL PLLC
Active
Organization
TPHAN DENTAL PLLC
Active
Other names
Moment Dental
Organization subpart
No
Provider details
NPI number
Authorized official
TRUNG PHAN DDS (OWNER)
(703) 608-3760
Entity
Organization
Contact information
Practice address
581 UNIVERSITY BLVD STE 400, ROUND ROCK, TX 78665-1068
(512) 244-3333
Mailing address
581 UNIVERSITY BLVD STE 400, ROUND ROCK, TX 78665-1068
(512) 244-3333
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1902391972
NPI
—
Enumeration date
12/08/2021
Last updated
11/23/2022
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