Provider Demographics
NPI:1750666509
Name:DAVID M. GARRETT D.D.S.,INC.
Entity Type:Organization
Organization Name:DAVID M. GARRETT D.D.S.,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JATHEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:GARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:409-962-1964
Mailing Address - Street 1:5711 39TH ST
Mailing Address - Street 2:
Mailing Address - City:GROVES
Mailing Address - State:TX
Mailing Address - Zip Code:77619-3613
Mailing Address - Country:US
Mailing Address - Phone:409-962-1964
Mailing Address - Fax:409-962-6445
Practice Address - Street 1:5711 39TH ST
Practice Address - Street 2:
Practice Address - City:GROVES
Practice Address - State:TX
Practice Address - Zip Code:77619-3613
Practice Address - Country:US
Practice Address - Phone:409-962-1964
Practice Address - Fax:409-962-6445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-12
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental