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10080 Bellaire Boulevard Ste 210 Houston TX 77072 | |
| (281) 575-0742 | |
| (281) 575-0298 |
| Full Name | |
|---|---|
| Speciality | Dentist - Prosthodontics |
| Location | 10080 Bellaire Boulevard, Houston, Texas |
| Authorized Official Name and Position | Amy L Ridall (PRESIDENT/TREASURER) |
| Authorized Official Contact | 7132715942 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
10080 Bellaire Boulevard Ste 210 Houston TX 77072 Ph: (281) 575-0742 | 10080 Bellaire Boulevard Ste 210 Houston TX 77072 Ph: (281) 575-0742 |
| NPI Number | 1699787432 |
|---|---|
| Provider Enumeration Date | 08/12/2006 |
| Last Update Date | 01/22/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699787432 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0700X | Dentist - Prosthodontics | 18563 (Texas) | Primary |
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