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8614 S Braeswood Blvd Houston TX 77031-1301 | |
| (713) 777-3368 | |
| (713) 777-3370 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 8614 S Braeswood Blvd, Houston, Texas |
| Authorized Official Name and Position | Winifred O Dike (DENTIST) |
| Authorized Official Contact | 7137773368 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
8614 S Braeswood Blvd Houston TX 77031-1301 Ph: (713) 777-3368 | 8614 S Braeswood Blvd Houston TX 77031-1301 Ph: (713) 777-3368 |
| NPI Number | 1457406647 |
|---|---|
| Provider Enumeration Date | 01/25/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457406647 | NPI | - | NPPES |
| 000000272850 | Other | CARRINGTON PPO | |
| B2163701 | Other | TX | CHIPS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 21637 (Texas) | Primary |
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