| Family Dental Group Of Greenville Pllc | |
|
4319 Ridgecrest Rd Greenville TX 75402-6004 | |
| (903) 454-0918 | |
| (903) 454-0311 |
| Full Name | Family Dental Group Of Greenville Pllc |
|---|---|
| Speciality | Dentist |
| Location | 4319 Ridgecrest Rd, Greenville, Texas |
| Authorized Official Name and Position | Gary Randall Evans (MEMBER) |
| Authorized Official Contact | 9034540918 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Dental Group Of Greenville Pllc 4319 Ridgecrest Rd Greenville TX 75402-6004 Ph: (903) 454-0918 | Family Dental Group Of Greenville Pllc 4319 Ridgecrest Rd Greenville TX 75402-6004 Ph: (903) 454-0918 |
| NPI Number | 1881135044 |
|---|---|
| Provider Enumeration Date | 03/20/2017 |
| Last Update Date | 03/20/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881135044 | NPI | - | NPPES |
| 1223G0001X | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 11800 (Texas) | Primary |
Greenville Pediatric Dentistry, P.a. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3101 Joe Ramsey Blvd E, Suite 103a, Greenville, TX 75401 Phone: 903-454-0771 | |
Dr. G. Randall Evans, D.d.s., F.a.g.d. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 4319 Ridgecrest Rd, Greenville, TX 75402 Phone: 903-454-0918 Fax: 903-454-7540 | |
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Ronald D Weaks Dds Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 4250 Joe Ramsey Blvd, Greenville, TX 75401 Phone: 903-455-4161 Fax: 903-455-7510 | |
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