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Organization
GAINESVILLE FAMILY DENTISTRY, PC
Active
Organization
GAINESVILLE FAMILY DENTISTRY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW TOM RECORD D,D.S. (OWNER/PRESIDENT)
(940) 665-4761
Entity
Organization
Contact information
Practice address
212 S GRAND AVE, GAINESVILLE, TX 76240-5013
(940) 665-4761
Mailing address
212 S GRAND AVE, GAINESVILLE, TX 76240-5013
(940) 665-4761
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19728
TX
1223G0001X
General Practice Dentistry
22036
TX
Other
Enumeration date
06/03/2010
Last updated
06/03/2010
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