Organization
GULF COAST DENTAL - BAY CITY
Active
Parent organization
OCEANSIDE DENTAL ARTS, LP
Organization subpart
Yes
Provider details
NPI number
Legal business name
OCEANSIDE DENTAL ARTS, LP
Authorized official
DIEP PHAM DDS (OWNER)
(979) 245-2104
Entity
Organization
Contact information
Practice address
2521 AVENUE H, BAY CITY, TX 77414-6029
(979) 245-2104
Mailing address
PO BOX 1569, LAKE JACKSON, TX 77566-1569
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
12472
TX
122300000X
Dentist
Primary
17862
TX
122300000X
Dentist
24866
TX
Other
Enumeration date
06/10/2014
Last updated
06/10/2014
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