Provider Demographics
NPI:1760030514
Name:DENTAHUB OF GARLAND
Entity type:Organization
Organization Name:DENTAHUB OF GARLAND
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:GARZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-706-7057
Mailing Address - Street 1:126 N INTERNATIONAL RD STE A
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042-6515
Mailing Address - Country:US
Mailing Address - Phone:972-295-9631
Mailing Address - Fax:972-295-9632
Practice Address - Street 1:126 N INTERNATIONAL RD STE A
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-6515
Practice Address - Country:US
Practice Address - Phone:972-295-9631
Practice Address - Fax:972-295-9632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-26
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty