| NPI | 1205449584 |
|---|---|
| Doing Business As | COASTAL PERIODONTICS |
| Entity Type | Organization |
| Authorized Contact | FAITH GASKINS Director Of Credentialing 972-869-3789 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics |
| Enumeration Date | 2020-08-26 |
| Last Update Date | 2020-08-26 |