Organization
STATE 48 DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN TRUONG DMD (PRINCIPAL)
(602) 312-1348
Entity
Organization
Contact information
Practice address
5122 N 95TH AVE STE A100, GLENDALE, AZ 85305-3044
(602) 312-1348
Mailing address
5122 N 95TH AVE STE A100, GLENDALE, AZ 85305-3044
(602) 312-1348
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
05/02/2021
Last updated
05/02/2021
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