| First Colony Mall Dental Pa | |
|
16535 Southwest Fwy 570 Sugar Land TX 77479-2321 | |
| (954) 846-7171 | |
| Not Available |
| Full Name | First Colony Mall Dental Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 16535 Southwest Fwy, Sugar Land, Texas |
| Authorized Official Name and Position | Rostislav Krasnov (OWNER) |
| Authorized Official Contact | 9548467171 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| First Colony Mall Dental Pa 16535 Southwest Fwy 570 Sugar Land TX 77479-2321 Ph: () - | First Colony Mall Dental Pa 16535 Southwest Fwy 570 Sugar Land TX 77479-2321 Ph: (954) 846-7171 |
| NPI Number | 1154738151 |
|---|---|
| Provider Enumeration Date | 07/22/2014 |
| Last Update Date | 07/22/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154738151 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 27827 (Texas) | Primary |
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