Sd Texarkana

NPI #1982246690 in Texarkana, Texas

Provider Information

NPI Number: 1982246690
Entity Type: Organization
Organization Name: Sd Texarkana
Primary Specialty: Dentist - General Practice
Enumeration Date: Oct 14, 2019
Last Updated: Oct 14, 2019

Practice Location

Address: 3225 KENNEDY LN
City: Texarkana
State: Texas
ZIP Code: 75503-2428
Phone: (903) 306-2384

Authorized Official

Name: DR. LYNHTHY T PHAM, DDS
Title: OWNER
Phone: (214) 466-1400

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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