Healthcare Provider Details

I. General information

NPI: 1427086883
Provider Name (Legal Business Name): GARTH ROBERT GRIFFITHS D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 S LANCASTER RD DENTAL (160)
DALLAS TX
75216-7167
US

IV. Provider business mailing address

4500 S LANCASTER RD DENTAL (160)
DALLAS TX
75216-7167
US

V. Phone/Fax

Practice location:
  • Phone: 214-857-1097
  • Fax: 214-857-0212
Mailing address:
  • Phone: 214-857-1097
  • Fax: 214-857-0212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number13340
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: