| NPI | 1720355381 |
|---|---|
| Doing Business As | TIDE DENTAL |
| Entity Type | Organization |
| Authorized Contact | FAITH GASKINS Director Of Credentialing 972-869-3789 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2011-11-28 |
| Last Update Date | 2022-11-02 |