Individual
DR. AJAY GANTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MD
Contact information
Practice address
2300 W FM 544 STE 240, WYLIE, TX 75098-4931
(469) 596-7722
(469) 596-7720
Mailing address
2300 W FM 544 STE 240, WYLIE, TX 75098-4931
(469) 596-7722
(469) 596-7720
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
35033
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033759584
—
TX
05
—
1508008855
—
TX
Enumeration date
04/01/2009
Last updated
03/06/2020
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