Provider Demographics
NPI:1376017145
Name:PDB DENTAL PLLC
Entity Type:Organization
Organization Name:PDB DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:AMIT
Authorized Official - Middle Name:
Authorized Official - Last Name:GABA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:713-299-2678
Mailing Address - Street 1:4310 7TH ST STE 800
Mailing Address - Street 2:
Mailing Address - City:BAYCITY
Mailing Address - State:TX
Mailing Address - Zip Code:77414
Mailing Address - Country:US
Mailing Address - Phone:979-245-2277
Mailing Address - Fax:979-245-2287
Practice Address - Street 1:4310 7TH ST STE 800
Practice Address - Street 2:
Practice Address - City:BAYCITY
Practice Address - State:TX
Practice Address - Zip Code:77414
Practice Address - Country:US
Practice Address - Phone:979-245-2277
Practice Address - Fax:979-245-2287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-15
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty