Provider Demographics
NPI:1598825242
Name:DALI DENTAL, P.A.
Entity Type:Organization
Organization Name:DALI DENTAL, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAO
Authorized Official - Middle Name:M
Authorized Official - Last Name:PHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-517-8090
Mailing Address - Street 1:7801 ALMA DR
Mailing Address - Street 2:123
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-3482
Mailing Address - Country:US
Mailing Address - Phone:972-517-8090
Mailing Address - Fax:972-517-8050
Practice Address - Street 1:7801 ALMA DR
Practice Address - Street 2:123
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75025-3482
Practice Address - Country:US
Practice Address - Phone:972-517-8090
Practice Address - Fax:972-517-8050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty