Provider Demographics
NPI:1922341643
Name:CORNERSTONE FAMILY DENTISTRY, PLLC
Entity Type:Organization
Organization Name:CORNERSTONE FAMILY DENTISTRY, PLLC
Other - Org Name:CORNERSTONE FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GIANG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-271-1302
Mailing Address - Street 1:3232 BROADWAY BLVD STE G
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-1563
Mailing Address - Country:US
Mailing Address - Phone:972-271-1302
Mailing Address - Fax:972-926-5033
Practice Address - Street 1:3232 BROADWAY BLVD STE G
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-1563
Practice Address - Country:US
Practice Address - Phone:972-271-1302
Practice Address - Fax:972-926-5033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-01
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX00241581223G0001X
TX00222001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty