DENTAL BOAT CLUB P.C
Managed Care Organizations at Boat Club Rd, Fort Worth, TX

License number
Texas 22593
Category
Managed Care Organizations
Type
Preferred Provider Organization
Owner
Name: DR. HAIDUONG H NGUYEN DDS
Title: OWNER
Phone: (213) 862-0106
Address
Address
4625 Boat Club Rd STE 225, Fort Worth, TX 76135
National Provider ID: 1306112149
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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DENTAL BOAT CLUB, PC

Fort Worth, TX  -  Desoto, TX

Doing business as:
Compassionte Healthcare Services 76135A<br>Dental Boat Club, PC
Registration:
Aug 10, 2011
Addresses:
7936 Salmon Run Way, Fort Worth, TX 76137 (Mailing)
1321 Wolf Crk Dr, Desoto, TX 75115
4625 Boat Clb Rd, Fort Worth, TX 76135
State ID:
0801464325
Business type:
Domestic Professional Corporation
Directors:
Hai Duong Nguyen (DIRECTOR, Director, President),Haiduong Nauyen Director, President, inactive,Haiduong Nguyen Director, inactive
TIN:
32044819988

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