Organization
EPIC WEST FAMILY DNETISTRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NINA DINH DDS (OWNER)
(972) 544-1592
Entity
Organization
Contact information
Practice address
3166 SH 161, STE 190, GRAND PRAIRIE, TX 75052
(972) 544-1592
Mailing address
3166 SH 161, STE 190, GRAND PRAIRIE, TX 75052
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1396000196
NPPES
TX
Enumeration date
10/07/2019
Last updated
10/07/2019
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