Organization
FAMILY TREE DENTISTRY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOAN T BUI DDS (DENTIST)
(817) 520-0520
Entity
Organization
Contact information
Practice address
8190 PRECINCT LINE STE 200, COLLEYVILLE, TX 76034-7675
(817) 520-0520
(817) 520-0525
Mailing address
8190 PRECINCT LINE STE 200, COLLEYVILLE, TX 76034-7675
(817) 520-0520
(817) 520-0525
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
21783
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
165664704
MEDICAID
TX
Enumeration date
05/13/2008
Last updated
05/13/2008
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