Provider Demographics
NPI:1689926636
Name:STELLAR IMPLANTS, PLLC
Entity Type:Organization
Organization Name:STELLAR IMPLANTS, PLLC
Other - Org Name:STELLAR IMPLANT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SON
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:214-747-1400
Mailing Address - Street 1:2515 MCKINNEY AVE
Mailing Address - Street 2:STE 940
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201-1908
Mailing Address - Country:US
Mailing Address - Phone:972-747-1400
Mailing Address - Fax:
Practice Address - Street 1:2911 TURTLE CREEK BLVD
Practice Address - Street 2:STE 275
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-6247
Practice Address - Country:US
Practice Address - Phone:214-932-3399
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-15
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX209601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty