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General NPI Number Information
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NPI Number | 1609472976
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Entity Type | Organization
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Legal Business Name | APG DENTAL, PA
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Dates
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Enumeration Date | 12/10/2020
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Last Update Date | 04/19/2022
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Provider Practice Location Address
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Address Line | 2213 MCDERMOTT RD
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City | PLANO
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State | TX
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Zip | 75025-4613
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Country | US
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Telephone | 214-256-7330
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Fax |
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Provider Business Mailing Address
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Address Line | 639 KINNEY DR
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City | MURPHY
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State | TX
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Zip | 75094-3318
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Country | US
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Telephone | 972-824-5850
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Fax |
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Authorized Official
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Title or Position | PEDIATRIC DENTIST, CORPORATE OWNER
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Name | DR. ANDREA PILAR GONZALES
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Credential | DDS, MS
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Telephone | 972-824-5850
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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