Organization
ACCESS DENTAL OF PARK LAKE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIEN DINH PHAN DMD (DENTIST)
(972) 514-1689
Entity
Organization
Contact information
Practice address
1925 PARK LAKE DR, WACO, TX 76708-1682
(972) 514-1689
Mailing address
8150 SPRINGWOOD DR # 150B, IRVING, TX 75063-5810
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22334
TX
Other
Enumeration date
04/07/2016
Last updated
10/25/2021
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