Provider Demographics
NPI:1861897001
Name:VILLAGE DENTAL HEALTH
Entity type:Organization
Organization Name:VILLAGE DENTAL HEALTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:H
Authorized Official - Last Name:GERLACH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-964-1855
Mailing Address - Street 1:5425 W SPRING CREEK PKWY
Mailing Address - Street 2:165
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-4236
Mailing Address - Country:US
Mailing Address - Phone:972-964-1855
Mailing Address - Fax:972-943-9301
Practice Address - Street 1:2450 E PROSPER TRL
Practice Address - Street 2:30
Practice Address - City:PROSPER
Practice Address - State:TX
Practice Address - Zip Code:75078-9147
Practice Address - Country:US
Practice Address - Phone:972-347-2233
Practice Address - Fax:972-347-2237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-30
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX196481223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1013219732OtherDENTAL
TX1720231574OtherDENTAL