Michael B Gardner PC

NPI #1912271420 in Kilgore, Texas

Provider Information

NPI Number: 1912271420
Entity Type: Organization
Organization Name: Michael B Gardner PC
Primary Specialty: Clinic/Center - Dental
Enumeration Date: Mar 1, 2012
Last Updated: Mar 1, 2012

Practice Location

Address: 1806 BROADWAY BLVD
City: Kilgore
State: Texas
ZIP Code: 75662-3520
Phone: (903) 984-1108

Authorized Official

Name: MICHAEL GARDNER, DDS
Title: PRESIDENT
Phone: (903) 984-1108

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Dental — Dental	261QD0000X	Primary

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