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Organization
GEORGE ROAD DENTAL PLLC
Active
Organization
GEORGE ROAD DENTAL PLLC
Active
Other names
Legacy Dental SA
Organization subpart
No
Provider details
NPI number
Authorized official
FAITH GASKINS (DIRECTOR OF CREDENTIALING)
(972) 869-3789
Entity
Organization
Contact information
Practice address
13205 GEORGE RD, SAN ANTONIO, TX 78230-3018
(210) 361-8905
(210) 492-0305
Mailing address
13205 GEORGE RD, SAN ANTONIO, TX 78230-3018
(210) 361-8905
(210) 492-0305
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/12/2022
Last updated
01/12/2022
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