Individual
DR. GARY BRIAN SOUTHERLAND
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1910 BIRDCREEK DR, TEMPLE, TX 76502-1001
(254) 773-6373
(254) 773-6582
Mailing address
1910 BIRDCREEK DR, TEMPLE, TX 76502-1001
(254) 773-6373
(254) 773-6582
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
15454
TX
Other
Enumeration date
06/10/2005
Last updated
07/08/2007
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