# DOMINO DENTAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1932917044
- **Authorized official:** VANPHAPHONE LINAVONG (DDS)
- **Authorized official phone:** (469) 569-2367

## Contact information

- **Practice address:** 2425 S COCKRELL HILL RD, DALLAS, TX 75211-8103
- **Practice address phone:** (972) 285-2600
- **Mailing address:** 1150 E ELDORADO PKWY STE 100, LITTLE ELM, TX 75068-5502
- **Mailing address phone:** (972) 292-3092

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 12/20/2024
- **Last updated:** 12/20/2024