Provider Demographics
NPI:1487955597
Name:TRUCARE DENTAL, P.A.
Entity type:Organization
Organization Name:TRUCARE DENTAL, P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THANH-TRUC
Authorized Official - Middle Name:NGOC
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-864-0000
Mailing Address - Street 1:3031 S 1ST ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75041-3459
Mailing Address - Country:US
Mailing Address - Phone:972-864-0000
Mailing Address - Fax:
Practice Address - Street 1:3031 S 1ST ST
Practice Address - Street 2:SUITE 500
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75041-3459
Practice Address - Country:US
Practice Address - Phone:972-864-0000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-04
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX246581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty