Organization
110 DENTISTRY & ORTHODONTICS PLLC
Active
Other names
110 Dental & Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
FAITH GASKINS (DIRECTOR OF CREDENTIALING)
(972) 869-3789
Entity
Organization
Contact information
Practice address
308 HWY 110 N STE A, WHITEHOUSE, TX 75791-3112
(972) 590-8809
(972) 619-7622
Mailing address
PO BOX 734753, DALLAS, TX 75373-3112
(972) 590-8809
(972) 619-7622
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/22/2021
Last updated
01/11/2022
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