Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Fresh Dental PLLC

Organization Dentist · NPI 1093000804

Fresh Dental PLLC is a Dentist in Tyler, Texas. Registered with an NPI since 2011.

In the registry since
2011
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3873 Hwy 64 W
Tyler, TX 75704-6925
Phone: (972) 869-3789
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X

Record details

NPI number1093000804
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mary Pu — Cfo · (972) 869-3789
Other names Fresh Dental & Orthodontics
NPI enumeratedJune 9, 2011
Last updated in NPPESApril 25, 2023
Certification dateApril 25, 2023
Mailing addressPo Box 734753, Dallas, TX 75373-4753

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