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Organization
RED RIVER FAMILY DENTAL, PLLC
Active
Organization
RED RIVER FAMILY DENTAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN DALE STEWART DMD (OWNER)
(702) 376-7374
Entity
Organization
Contact information
Practice address
1320 N GRAND AVE, UNIT B, GAINESVILLE, TX 76240-2813
(702) 376-7374
Mailing address
1102 ASPEN RD, GAINESVILLE, TX 76240-2947
(702) 376-7374
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
24935
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1295049781
—
TX
Enumeration date
07/16/2013
Last updated
07/16/2013
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