Gayle J Fletcher, DDS

Individual provider Active NPI General Practice Dentistry · Willis, TX

NPI 1649369786 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1649369786
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
16498 (TX)
Practice address
904 W Montgomery
Suite 7
Willis, TX 77378
Phone
(936) 856-9969
Fax
(936) 856-9970
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
16498TXMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 16498 TX Yes

Addresses

Primary practice location

904 W Montgomery
Suite 7
Willis, TX 77378

Mailing address

904 W Montgomery
Suite 7
Willis, TX 77378
Phone (936) 856-9969

Other providers in Willis, TX

All providers in Willis, TX · General Practice Dentistry in Texas

Sources for this page

Verify at the official NPI Registry.