Organization
GALENA PARK DENTAL
Active
Other names
GALENA PARK DENTAL
Organization subpart
No
Provider details
NPI number
Authorized official
MARY N PHAN (DOCTOR)
(713) 672-4779
Entity
Organization
Contact information
Practice address
1705 CLINTON DR, GALENA PARK, TX 77547-3224
(713) 672-4479
Mailing address
1705 CLINTON DR, GALENA PARK, TX 77547-3224
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22483
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
178688101
—
TX
Enumeration date
12/11/2007
Last updated
09/23/2008
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