Organization
LA COSTA DENTAL OF LEOPARD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIEN DINH PHAN DMD (DENTIST)
(817) 531-3500
Entity
Organization
Contact information
Practice address
3505 LEOPARD ST, CORPUS CHRISTI, TX 78408-3203
(817) 531-3500
(817) 531-3501
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
04/02/2014
Last updated
10/25/2021
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