La Costa of Port Arthur PA
NPI #1942656509 in Port Arthur, Texas
Provider Information
- NPI Number
- 1942656509
- Entity Type
- Organization
- Organization Name
- La Costa of Port Arthur PA
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- May 12, 2016
- Last Updated
- Oct 4, 2021
Practice Location
- Address
- 8035 MEMORIAL BLVD
- City
- Port Arthur
- State
- Texas
- ZIP Code
- 77640-7002
- Phone
- (972) 514-1689
Authorized Official
- Name
- TIEN DINH PHAN, DMD
- Title
- DENTIST
- Phone
- (972) 514-1689
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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