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Organization
GULF COAST DENTAL PC
Active
Organization
GULF COAST DENTAL PC
Active
Other names
Kavitha Ginjupalli DDS PC
Organization subpart
No
Provider details
NPI number
Authorized official
KAVITHA GINJUPALLI D.D.S (PRESIDENT)
(979) 480-9300
Entity
Organization
Contact information
Practice address
309 GARLAND DR, LAKE JACKSON, TX 77566-6238
(979) 480-9300
(979) 480-9310
Mailing address
309 GARLAND DR, LAKE JACKSON, TX 77566-6238
(979) 480-9300
(979) 480-9310
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19499
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0912784-01
—
TX
Enumeration date
04/17/2007
Last updated
08/12/2008
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