Provider Demographics
NPI:1063019081
Name:PGP PLLC
Entity Type:Organization
Organization Name:PGP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:MARCUS
Authorized Official - Last Name:CHEI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:214-326-9077
Mailing Address - Street 1:2580 W CAMP WISDOM RD STE 300
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-3091
Mailing Address - Country:US
Mailing Address - Phone:972-408-0480
Mailing Address - Fax:972-525-0971
Practice Address - Street 1:2580 W CAMP WISDOM RD STE 300
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-3091
Practice Address - Country:US
Practice Address - Phone:972-408-0480
Practice Address - Fax:972-525-0971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-02
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental