Healthcare Provider Details

I. General information

NPI: 1326125915
Provider Name (Legal Business Name): SUSAN GEHM FRANCIS D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 BELLMEAD DR
WACO TX
76705-3077
US

IV. Provider business mailing address

3200 BELLMEAD DR
WACO TX
76705-3077
US

V. Phone/Fax

Practice location:
  • Phone: 254-799-4000
  • Fax: 254-799-4035
Mailing address:
  • Phone: 254-799-4000
  • Fax: 254-799-4035

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number19253
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: