Fresh Dental Pllc

NPI #1093000804 in Tyler, Texas

Provider Information

NPI Number: 1093000804
Entity Type: Organization
Organization Name: Fresh Dental Pllc
Primary Specialty: Dentist
Enumeration Date: Jun 9, 2011
Last Updated: Apr 25, 2023

Practice Location

Address: 3873 HWY 64 W
City: Tyler
State: Texas
ZIP Code: 75704-6925
Phone: (972) 869-3789

Authorized Official

Name: MARY PU
Title: CFO
Phone: (972) 869-3789

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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