# ACRE WOOD DENTAL - GATESVILLE PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225675366
- **Authorized official:** KISHA L FUENTES (OFFICE MANAGER)
- **Authorized official phone:** (254) 778-4951

## Contact information

- **Practice address:** 105 N LUTTERLOH AVE, GATESVILLE, TX 76528-1421
- **Practice address phone:** (254) 865-7918
- **Practice address fax:** (254) 248-0529
- **Mailing address:** 105 N LUTTERLOH AVE, GATESVILLE, TX 76528-1421
- **Mailing address phone:** (254) 865-7918
- **Mailing address fax:** (254) 248-0529

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 12/09/2019
- **Last updated:** 12/09/2019