Organization
MAGNOLIA DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GERARD THOMAS MACY DDS (DENTIST)
(903) 603-4406
Entity
Organization
Contact information
Practice address
507 N 3RD ST, MABANK, TX 75147-8328
(903) 603-4406
(903) 201-6787
Mailing address
507 N 3RD ST, MABANK, TX 75147-8328
(903) 603-4406
(903) 201-6787
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
22174
TX
Other
Enumeration date
02/28/2018
Last updated
02/28/2018
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