Organization
GLEAM DENTAL LLC
Active
Parent organization
GLEAM DENTAL
Organization subpart
Yes
Provider details
NPI number
Legal business name
GLEAM DENTAL
Authorized official
FIELD G. HARRISON DDS (OWNER/PROVIDER)
(972) 573-6100
Entity
Organization
Contact information
Practice address
3636 N. MACAURTHUR, STE 140, IRVING, TX 75062
(972) 573-6100
(972) 573-6105
Mailing address
3636 N. MACAURTHUR, STE. 140, IRVING, TX 75062
(972) 573-6100
(972) 573-6105
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
23874
TX
122300000X
Dentist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
TPI205977609
—
TX
Enumeration date
02/15/2012
Last updated
02/15/2012
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