# GULFSIDE DENTAL PORT ARTHUR PLLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1316325616
- **Authorized official:** MARY PU (VP OF FINANCE)
- **Authorized official phone:** (972) 869-3789

## Contact information

- **Practice address:** 2780 HWY 365, SUITE C, PORT ARTHUR, TX 77640
- **Practice address phone:** (409) 433-9254
- **Mailing address:** PO BOX 734753, DALLAS, TX 75373-4753
- **Mailing address phone:** (972) 869-3789

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 05/07/2015
- **Last updated:** 10/26/2022