TX SOUTHERN DENTAL PPO PC

COLLEYVILLE, TX
NPI1518772052
Doing Business AsGATEWAY DENTAL
Entity TypeOrganization
Authorized ContactERIKA MELISSA MENJIVAR
Sr. Credentialing Specialist
469-596-6137
Organization Subpart ?Yes
Primary Taxonomy122300000X Dentist
Enumeration Date2025-02-11
Last Update Date2025-02-11
Business Address
TX SOUTHERN DENTAL PPO PC
4013 GATEWAY DR
COLLEYVILLE, TX 76034-5917
Phone number: 817-369-8007
Mailing Address
TX SOUTHERN DENTAL PPO PC
5830 GRANITE PKWY STE 780
PLANO, TX 75024-6775
Phone number: