| Northwest Family Dentistry | |
|
2120 W 18th St Houston TX 77008-1210 | |
| (713) 861-7078 | |
| (713) 861-8065 |
| Full Name | Northwest Family Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2120 W 18th St, Houston, Texas |
| Authorized Official Name and Position | Andrew Wong (GENERAL PARTNER) |
| Authorized Official Contact | 7138617078 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northwest Family Dentistry 2120 W 18th St Houston TX 77008-1210 Ph: (713) 861-7078 | Northwest Family Dentistry 2120 W 18th St Houston TX 77008-1210 Ph: (713) 861-7078 |
| NPI Number | 1316080088 |
|---|---|
| Provider Enumeration Date | 02/14/2007 |
| Last Update Date | 05/29/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316080088 | NPI | - | NPPES |
| 009719801 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 15764 (Texas) | Primary |
| 1223G0001X | Dentist - General Practice | 15415 (Texas) | Secondary |
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