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Organization
GATESVILLE DENTAL PLLC
Active
Organization
GATESVILLE DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MONA AGARWAL DDS (OWNER/DENTIST)
(423) 943-1203
Entity
Organization
Contact information
Practice address
2416 S STATE HIGHWAY 36, GATESVILLE, TX 76528-2518
(254) 216-2612
Mailing address
5113 CEDAR BRUSH DR, FORT WORTH, TX 76123-2962
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
27214
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27214
TEXAS BOARD OF DENTAL EXAMINERS
TX
Enumeration date
04/09/2018
Last updated
04/09/2018
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