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Organization
GULFSIDE DENTAL - LA MARQUE PLLC
Active
Organization
GULFSIDE DENTAL - LA MARQUE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FAITH GASKINS DIRECTOR (DIRECTOR OF CREDENTIALING)
(972) 869-3789
Entity
Organization
Contact information
Practice address
2600 FM 1764 RD STE 170, LA MARQUE, TX 77568-2828
(972) 590-8809
(972) 619-7622
Mailing address
PO BOX 734753, DALLAS, TX 75373-4753
(972) 869-3789
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/25/2018
Last updated
01/11/2022
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