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Organization
SOUTHERN GEM DENTAL
Active
Organization
SOUTHERN GEM DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY PU (VP OF FINANCE)
(972) 869-3789
Entity
Organization
Contact information
Practice address
7301 STATE HIGHWAY 161 STE 198, IRVING, TX 75039-2880
(972) 869-3789
(972) 869-3791
Mailing address
7301 STATE HIGHWAY 161 STE 198, IRVING, TX 75039-2880
(972) 869-3789
(972) 869-3791
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
02/28/2012
Last updated
02/28/2012
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