Provider Demographics
NPI:1689822074
Name:MINHDAI INVESTMENT
Entity Type:Organization
Organization Name:MINHDAI INVESTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:PHUONG
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:817-461-3540
Mailing Address - Street 1:1120 E PIONEER PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76010-6400
Mailing Address - Country:US
Mailing Address - Phone:817-461-3540
Mailing Address - Fax:817-303-8046
Practice Address - Street 1:2615 W PIONEER PKWY STE 102
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75051-3536
Practice Address - Country:US
Practice Address - Phone:214-788-2840
Practice Address - Fax:214-788-2860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-28
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty