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827 Magnolia Blvd Ste 1 Magnolia TX 77355-8553 | |
| (281) 356-3721 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 827 Magnolia Blvd Ste 1, Magnolia, Texas |
| Authorized Official Name and Position | Matt Hale (AUTHORIZED REPRESENTATIVE) |
| Authorized Official Contact | 2147020720 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
827 Magnolia Blvd Ste 1 Magnolia TX 77355-8553 Ph: (281) 356-3721 | 827 Magnolia Blvd Ste 1 Magnolia TX 77355-8553 Ph: (281) 356-3721 |
| NPI Number | 1326758137 |
|---|---|
| Provider Enumeration Date | 12/02/2022 |
| Last Update Date | 12/02/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326758137 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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