Provider Demographics
NPI:1982994323
Name:CWC DENTAL PLLC
Entity Type:Organization
Organization Name:CWC DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GEETA
Authorized Official - Middle Name:
Authorized Official - Last Name:GULATI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-254-2273
Mailing Address - Street 1:1107 S. MACARTHUR BLVD
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75060
Mailing Address - Country:US
Mailing Address - Phone:972-254-2273
Mailing Address - Fax:972-254-2275
Practice Address - Street 1:1107 S. MACARTHUR BLVD
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75060
Practice Address - Country:US
Practice Address - Phone:972-254-2273
Practice Address - Fax:972-254-2275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-19
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19205122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty