Provider Demographics
NPI:1376687533
Name:ROYAL CROWN DENTAL PA
Entity Type:Organization
Organization Name:ROYAL CROWN DENTAL PA
Other - Org Name:ROYAL CROWN DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:DUC
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-701-8282
Mailing Address - Street 1:14215 COIT RD
Mailing Address - Street 2:#112
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-2800
Mailing Address - Country:US
Mailing Address - Phone:972-701-8282
Mailing Address - Fax:972-701-8284
Practice Address - Street 1:14215 COIT RD
Practice Address - Street 2:#112
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75254-2800
Practice Address - Country:US
Practice Address - Phone:972-701-8282
Practice Address - Fax:972-701-8284
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty