Organization
CONGLOMERATE PLLC
Active
Other names
The Grand Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARESEA WOODS DDS (DENTIST/PART-OWNER)
(334) 590-4223
Entity
Organization
Contact information
Practice address
1620 GRAND AVENUE PKWY STE 130, PFLUGERVILLE, TX 78660-2185
(512) 670-8482
Mailing address
1620 GRAND AVENUE PKWY STE 130, PFLUGERVILLE, TX 78660-2185
(512) 670-8482
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
03/02/2020
Last updated
04/09/2020
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