| Dentaspa PLLC | |
|
2960 Interstate 45 N Ste 300 Conroe TX 77303-7912 | |
| (909) 471-3670 | |
| (210) 447-7088 |
| Full Name | Dentaspa PLLC |
|---|---|
| Speciality | Dentist |
| Location | 2960 Interstate 45 N Ste 300, Conroe, Texas |
| Authorized Official Name and Position | Haitham Al-salman (OWNER) |
| Authorized Official Contact | 9094713670 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dentaspa PLLC 2960 Interstate 45 N Ste 300 Conroe TX 77303-7912 Ph: (909) 471-3670 | Dentaspa PLLC 2960 Interstate 45 N Ste 300 Conroe TX 77303-7912 Ph: (909) 471-3670 |
| NPI Number | 1285106716 |
|---|---|
| Provider Enumeration Date | 12/21/2018 |
| Last Update Date | 10/28/2022 |
| Certification Date | 10/28/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285106716 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | () | Primary |
| 1223G0001X | Dentist - General Practice | () | Secondary |
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