Organization
BLUEBONNET DENTAL, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THANH NGUYEN FERNANDEZ (PRESIDENT)
(972) 242-5890
Entity
Organization
Contact information
Practice address
2150 N JOSEY LN, SUITE 306, CARROLLTON, TX 75006-2991
(972) 242-5890
(972) 242-5906
Mailing address
2150 N JOSEY LN, SUITE 306, CARROLLTON, TX 75006-2991
(972) 242-5890
(972) 242-5906
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
02/12/2008
Last updated
02/12/2008
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