Organization
KOOL SMILES IN FT. WAYNE, PC
Active
Other names
Pippin Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TU TRAN DDS (PRESIDENT)
(770) 916-5036
Entity
Organization
Contact information
Practice address
1852 BLUFFTON ROAD, FT. WAYNE, IN 46809
(260) 479-1086
(260) 478-4678
Mailing address
1090 NORTHCHASE PKWY SE STE 150, MARIETTA, GA 30067-6407
(770) 916-5028
(678) 247-7858
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
Other
Enumeration date
10/06/2006
Last updated
03/22/2019
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