| |
110 E. Ninth Street Tyler TX 75701 | |
(903) 593-6585 | |
(903) 593-7645 |
Full Name | |
---|---|
Speciality | Dentist - General Practice |
Location | 110 E. Ninth Street, Tyler, Texas |
Authorized Official Name and Position | Matthew Hans Gillespie (PRESIDENT) |
Authorized Official Contact | 9035936585 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
110 E. Ninth Street Tyler TX 75701 Ph: (903) 593-6585 | 110 E. Ninth Street Tyler TX 75701 Ph: (903) 593-6585 |
NPI Number | 1851652291 |
---|---|
Provider Enumeration Date | 06/01/2012 |
Last Update Date | 02/18/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1851652291 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | (* (Not Available)) | Secondary |
1223G0001X | Dentist - General Practice | 25547 (Texas) | Primary |
Kim Fretty Orthodontics Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6989 Highlands Ln, Tyler, TX 75703 Phone: 903-561-7873 | |
Pediatric Dentistry Of Tyler, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3607 Old Jacksonville Rd, Tyler, TX 75701 Phone: 903-595-5476 | |