| Gulfside Dental - La Marque Pllc | |
|
2600 Fm 1764 Rd Ste 170 La Marque TX 77568-2828 | |
| (972) 590-8809 | |
| (972) 619-7622 |
| Full Name | Gulfside Dental - La Marque Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2600 Fm 1764 Rd Ste 170, La Marque, Texas |
| Authorized Official Name and Position | Faith Gaskins (DIRECTOR OF CREDENTIALING) |
| Authorized Official Contact | 9728693789 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gulfside Dental - La Marque Pllc Po Box 734753 Dallas TX 75373-4753 Ph: (972) 869-3789 | Gulfside Dental - La Marque Pllc 2600 Fm 1764 Rd Ste 170 La Marque TX 77568-2828 Ph: (972) 590-8809 |
| NPI Number | 1083112932 |
|---|---|
| Provider Enumeration Date | 01/25/2018 |
| Last Update Date | 01/11/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083112932 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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