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Organization
SOUTH TYLER FAMILY DENTISTRY PLLC
Active
Organization
SOUTH TYLER FAMILY DENTISTRY PLLC
Active
Other names
Fresh Dental and Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
JENNY GARCIA (CREDENTIALING LEAD)
(972) 869-3789
Entity
Organization
Contact information
Practice address
8942 S BROADWAY AVE STE 128, TYLER, TX 75703-5443
(903) 594-4562
Mailing address
PO BOX 734753, DALLAS, TX 75373-4753
(972) 869-3789
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
08/19/2015
Last updated
11/21/2022
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