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Organization

FIFTH DENTAL PARTNER PLLC

Active
Other names
Tesla Dentistry
Organization subpart
No

Provider details

NPI number
Authorized official
ANDY CHANG DDS (OWNER)
(972) 360-0805
Entity
Organization

Contact information

Practice address
2831 W 15TH ST STE 200, PLANO, TX 75075-7527
(972) 360-0805
Mailing address
2831 W 15TH ST STE 100, PLANO, TX 75075-7527
(469) 208-9800

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1104040740
TX
Enumeration date
10/18/2019
Last updated
12/18/2020
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