Organization
DOMINO DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VANPHAPHONE LINAVONG (DDS)
(469) 569-2367
Entity
Organization
Contact information
Practice address
2425 S COCKRELL HILL RD, DALLAS, TX 75211-8103
(972) 285-2600
Mailing address
1150 E ELDORADO PKWY STE 100, LITTLE ELM, TX 75068-5502
(972) 292-3092
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
12/20/2024
Last updated
12/20/2024
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