# FAIRWAY DRIVE DENTISTRY PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Alvin Dental Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336764000
- **Authorized official:** FAITH GASKINS (DIRECTOR OF CREDENTIALING)
- **Authorized official phone:** (972) 869-3789

## Contact information

- **Practice address:** 1701 FAIRWAY DR STE 20, ALVIN, TX 77511-4678
- **Practice address phone:** (281) 331-0020
- **Practice address fax:** (281) 585-0505
- **Mailing address:** 1701 FAIRWAY DR STE 20, ALVIN, TX 77511-4678
- **Mailing address phone:** (281) 331-0020
- **Mailing address fax:** (281) 585-0505

## Taxonomy

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

## Other

- **Enumeration date:** 06/09/2020
- **Last updated:** 06/09/2020