Provider Demographics
NPI:1033986807
Name:ACGDDS HOLDINGS LLC
Entity Type:Organization
Organization Name:ACGDDS HOLDINGS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:GARZA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:361-437-9482
Mailing Address - Street 1:620 E SINTON ST
Mailing Address - Street 2:
Mailing Address - City:SINTON
Mailing Address - State:TX
Mailing Address - Zip Code:78387-2802
Mailing Address - Country:US
Mailing Address - Phone:361-364-4410
Mailing Address - Fax:361-364-3309
Practice Address - Street 1:5756 S STAPLES ST STE B
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413-3782
Practice Address - Country:US
Practice Address - Phone:361-994-5414
Practice Address - Fax:361-994-0022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty