| Airline Dental Clinic | |
|
5990 Airline Dr Suite 180 Houston TX 77076-4233 | |
| (713) 694-8333 | |
| (713) 694-8362 |
| Full Name | Airline Dental Clinic |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 5990 Airline Dr, Houston, Texas |
| Authorized Official Name and Position | Irasema Campa (ADMINISTRATIVE ASSISTANT) |
| Authorized Official Contact | 7136972631 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Airline Dental Clinic 1257 Archley Dr Houston TX 77055-6706 Ph: (713) 464-3326 | Airline Dental Clinic 5990 Airline Dr Suite 180 Houston TX 77076-4233 Ph: (713) 694-8333 |
| NPI Number | 1710011259 |
|---|---|
| Provider Enumeration Date | 03/15/2007 |
| Last Update Date | 02/01/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710011259 | NPI | - | NPPES |
| 169622101 | Medicaid | TX | |
| 177617101 | Medicaid | TX | |
| 009806301 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 22558 (Texas) | Primary |
| 1223G0001X | Dentist - General Practice | 16842 (Texas) | Secondary |
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