| Aquario Ortho | |
|
900 S Wayside Dr Ste 100 Houston TX 77023-3427 | |
| (832) 203-7968 | |
| Not Available |
| Full Name | Aquario Ortho |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 900 S Wayside Dr, Houston, Texas |
| Authorized Official Name and Position | Dustn Roden-johnson (OWNER) |
| Authorized Official Contact | 8322037968 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Aquario Ortho 5656 Bee Caves Rd Ste B104 Austin TX 78746 Ph: (832) 203-7968 | Aquario Ortho 900 S Wayside Dr Ste 100 Houston TX 77023-3427 Ph: (832) 203-7968 |
| NPI Number | 1528413358 |
|---|---|
| Provider Enumeration Date | 04/29/2016 |
| Last Update Date | 04/29/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528413358 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 22109 (Texas) | Primary |
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