Organization
GULFSIDE DENTAL PORT ARTHUR PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY PU (VP OF FINANCE)
(972) 869-3789
Entity
Organization
Contact information
Practice address
2780 HWY 365, SUITE C, PORT ARTHUR, TX 77640
(409) 433-9254
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
05/07/2015
Last updated
10/26/2022
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