| Texas Dental Holdings, Pllc | |
|
500 W Southlake Blvd #130 Southlake TX 76092-6163 | |
| (817) 991-9478 | |
| Not Available |
| Full Name | Texas Dental Holdings, Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 500 W Southlake Blvd #130, Southlake, Texas |
| Authorized Official Name and Position | Todd Gathright (PRESIDENT) |
| Authorized Official Contact | 8179919478 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Texas Dental Holdings, Pllc 500 W Southlake Blvd #130 Southlake TX 76092-6163 Ph: (817) 991-9478 | Texas Dental Holdings, Pllc 500 W Southlake Blvd #130 Southlake TX 76092-6163 Ph: (817) 991-9478 |
| NPI Number | 1487981072 |
|---|---|
| Provider Enumeration Date | 11/03/2009 |
| Last Update Date | 11/03/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487981072 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | TX20397 (Texas) | Primary |
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