Provider Demographics
NPI:1912418732
Name:VITA DENTAL GOSLING PLLC
Entity Type:Organization
Organization Name:VITA DENTAL GOSLING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SANG PIL
Authorized Official - Middle Name:
Authorized Official - Last Name:YU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:609-271-0278
Mailing Address - Street 1:5250 FM 2920 RD
Mailing Address - Street 2:STE D
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77388-3003
Mailing Address - Country:US
Mailing Address - Phone:609-271-0278
Mailing Address - Fax:
Practice Address - Street 1:5250 FM 2920 RD
Practice Address - Street 2:STE D
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77388-3003
Practice Address - Country:US
Practice Address - Phone:609-271-0278
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-19
Last Update Date:2017-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX260661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty