Organization
ACCESS DENTAL OF FREDERICKSBURG PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIEN DINH PHAN DMD (CEO)
(972) 514-1672
Entity
Organization
Contact information
Practice address
4315 FREDERICKSBURG BALCONES HEIGHT, 100A, SAN ANTONIO, TX 78201
(972) 514-1672
Mailing address
1200 W WALNUT HILL LN, 3950, IRVING, TX 75038-3029
(972) 514-1672
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22334
TX
Other
Enumeration date
09/06/2016
Last updated
09/06/2016
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