Provider Demographics
NPI:1982342572
Name:GARLAND DENTAL PLLC
Entity Type:Organization
Organization Name:GARLAND DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDOZA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:214-681-8628
Mailing Address - Street 1:5435 N GARLAND AVE STE 125
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-2723
Mailing Address - Country:US
Mailing Address - Phone:972-533-2458
Mailing Address - Fax:
Practice Address - Street 1:5435 N GARLAND AVE STE 125
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-2723
Practice Address - Country:US
Practice Address - Phone:972-533-2458
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-24
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty