| |
167 Citadel Way Ste 100 Sugar Land TX 77479-7162 | |
(713) 955-2100 | |
(713) 904-1806 |
Full Name | |
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Speciality | Dentist - Pediatric Dentistry |
Location | 167 Citadel Way Ste 100, Sugar Land, Texas |
Authorized Official Name and Position | Shilpa Jain Chandiwal (OWNER) |
Authorized Official Contact | 7139552100 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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167 Citadel Way Ste 100 Sugar Land TX 77479-7162 Ph: (713) 955-2100 | 167 Citadel Way Ste 100 Sugar Land TX 77479-7162 Ph: (713) 955-2100 |
NPI Number | 1295084820 |
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Provider Enumeration Date | 08/29/2012 |
Last Update Date | 08/29/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1295084820 | NPI | - | NPPES |
218348510 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223P0221X | Dentist - Pediatric Dentistry | 25305 (Texas) | Primary |
Dental Specialist Of Texas Pa Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 15200 Southwest Fwy Ste 120, Sugar Land, TX 77478 Phone: 281-494-2477 | |
Avalon Dental Group, P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2205 Williams Trace Blvd, Ste 108, Sugar Land, TX 77478 Phone: 281-240-5559 Fax: 281-240-5557 |