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General NPI Number Information
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NPI Number | 1316001506
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Entity Type | Organization
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Legal Business Name | GARLAND DENTAL ASSOCIATES, INC.
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Dates
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Enumeration Date | 12/21/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1213 W STATE ST SUITE A
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City | GARLAND
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State | TX
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Zip | 75040-6159
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Country | US
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Telephone | 972-272-3585
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Fax | 972-272-3589
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Provider Business Mailing Address
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Address Line | 1213 W STATE ST SUITE A
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City | GARLAND
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State | TX
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Zip | 75040-6159
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Country | US
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Telephone | 972-272-3585
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Fax | 972-272-3589
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RODGER D BAGBY
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Credential | D.D.S.
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Telephone | 972-272-3585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 1977
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License Number State | TX
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