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Michael B Gardner Pc
Dental Clinic/Center in Kilgore, Texas
NPI 1912271420

Michael B Gardner Pc is a Dental Clinic/Center based in Kilgore, TX and is specialized in Dental. Michael B Gardner Pc practices in Kilgore, TX. The NPI Number for Michael B Gardner Pc is 1912271420 and holds a License No. 25450 (Texas).

The current practice location address for Michael B Gardner Pc is 1806 Broadway Blvd, Kilgore, TX and can be reached out via phone at 903-984-1108.

Location: 1806 Broadway Blvd, Kilgore, TX, 75662-3520
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1912271420
Provider Name
Michael B Gardner Pc
Credential
Provider Entity Type
Organization
Address
1806 Broadway Blvd, Kilgore, TX, 75662-3520
Phone Number
903-984-1108
Fax Number
Provider Enumeration Date
03/01/2012
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
213519601 05 TX
institution
Provider Business Practice Location Address Details
Address
1806 Broadway Blvd
City
Kilgore
State
Texas
Zip
75662-3520
Phone Number
903-984-1108
Fax Number
person
Provider Business Mailing Address Details
Address
1806 Broadway Blvd
City
Kilgore
State
Texas
Zip
75662-3520
Phone Number
903-984-1108
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Dental
Taxonomy
261QD0000X
License No.
25450 (Texas)
Definition
Definition to come...
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