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General NPI Number Information
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NPI Number | 1245468982
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Entity Type | Organization
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Legal Business Name | GARY MOBLEY DDS INC
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Dates
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Enumeration Date | 07/01/2009
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Last Update Date | 07/01/2009
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Provider Practice Location Address
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Address Line | 2230 S EISENHOWER PKWY
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City | DENISON
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State | TX
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Zip | 75020-7724
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Country | US
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Telephone | 903-463-6013
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Fax | 903-463-1442
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Provider Business Mailing Address
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Address Line | 2230 S EISENHOWER PKWY
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City | DENISON
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State | TX
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Zip | 75020-7724
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Country | US
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Telephone | 903-463-6013
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Fax | 903-463-1442
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Authorized Official
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Title or Position | PRESIDENT
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Name | GARY MOBLEY
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Credential | DDS,M.SC.
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Telephone | 903-463-6013
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | TX9690
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | TX9690
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License Number State | TX
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