| Fifth Dental Partner Pllc | |
|
2831 W 15th St Ste 200 Plano TX 75075-7527 | |
| (972) 360-0805 | |
| Not Available |
| Full Name | Fifth Dental Partner Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2831 W 15th St Ste 200, Plano, Texas |
| Authorized Official Name and Position | Andy Chang (OWNER) |
| Authorized Official Contact | 9723600805 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fifth Dental Partner Pllc 2831 W 15th St Ste 100 Plano TX 75075-7527 Ph: (469) 208-9800 | Fifth Dental Partner Pllc 2831 W 15th St Ste 200 Plano TX 75075-7527 Ph: (972) 360-0805 |
| NPI Number | 1730722067 |
|---|---|
| Provider Enumeration Date | 10/18/2019 |
| Last Update Date | 12/18/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730722067 | NPI | - | NPPES |
| 1104040740 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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