Provider Demographics
NPI:1235321605
Name:ACCESS DENTAL OF SAGINAW
Entity Type:Organization
Organization Name:ACCESS DENTAL OF SAGINAW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TIEN
Authorized Official - Middle Name:DINH
Authorized Official - Last Name:PHAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:682-286-9300
Mailing Address - Street 1:601 N SAGINAW BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAGINAW
Mailing Address - State:TX
Mailing Address - Zip Code:76179-1224
Mailing Address - Country:US
Mailing Address - Phone:682-286-9300
Mailing Address - Fax:
Practice Address - Street 1:601 N SAGINAW BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:SAGINAW
Practice Address - State:TX
Practice Address - Zip Code:76179-1224
Practice Address - Country:US
Practice Address - Phone:682-286-9300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-09
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22334122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty