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14936 Northwest Fwy Houston TX 77040-4025 | |
| (713) 896-1512 | |
| (713) 849-3189 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 14936 Northwest Fwy, Houston, Texas |
| Authorized Official Name and Position | Leslie Bales (CEO) |
| Authorized Official Contact | 8326878694 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
14936 Northwest Fwy Houston TX 77040-4025 Ph: (713) 896-1512 | 14936 Northwest Fwy Houston TX 77040-4025 Ph: (713) 896-1512 |
| NPI Number | 1952664229 |
|---|---|
| Provider Enumeration Date | 06/20/2012 |
| Last Update Date | 06/20/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952664229 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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