Midentista, Pllc

NPI #1922335272 in Irving, Texas

Provider Information

NPI Number: 1922335272
Entity Type: Organization
Organization Name: Midentista, Pllc
Primary Specialty: Dentist
Enumeration Date: Nov 6, 2009
Last Updated: Nov 6, 2009

Practice Location

Address: 101 DECKER
Address 2: BLDG. 200, STE. 260
City: Irving
State: Texas
ZIP Code: 75062
Phone: (972) 717-0660

Authorized Official

Name: DR. ANGEL GONZALEZ JR., DDS
Title: PRESIDENT
Phone: (972) 717-0660

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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