Provider Demographics
NPI:1033640396
Name:GARLAND PEDIATRIC DENTISTRY
Entity Type:Organization
Organization Name:GARLAND PEDIATRIC DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DDS
Authorized Official - Prefix:DR
Authorized Official - First Name:BEHZAD
Authorized Official - Middle Name:
Authorized Official - Last Name:BAGHAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-500-9001
Mailing Address - Street 1:445 N GARLAND AVE
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-5646
Mailing Address - Country:US
Mailing Address - Phone:972-674-9966
Mailing Address - Fax:
Practice Address - Street 1:445 N GARLAND AVE
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-5646
Practice Address - Country:US
Practice Address - Phone:972-674-9966
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-27
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23664122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty