| La Michoacana Dental Clinic #2 | |
|
6500 Spencer Hwy Suite 120 Pasadena TX 77505-1704 | |
| (281) 416-4385 | |
| (281) 741-9546 |
| Full Name | La Michoacana Dental Clinic #2 |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 6500 Spencer Hwy, Pasadena, Texas |
| Authorized Official Name and Position | Adelina P Monty (OWNER) |
| Authorized Official Contact | 2814164385 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| La Michoacana Dental Clinic #2 6500 Spencer Hwy Suite 120 Pasadena TX 77505-1704 Ph: (281) 416-4385 | La Michoacana Dental Clinic #2 6500 Spencer Hwy Suite 120 Pasadena TX 77505-1704 Ph: (281) 416-4385 |
| NPI Number | 1265794317 |
|---|---|
| Provider Enumeration Date | 06/14/2012 |
| Last Update Date | 06/14/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265794317 | NPI | - | NPPES |
| 126781986 | Medicaid | TX | |
| 270255489 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 18185 (Texas) | Primary |
| 261QD0000X | Clinic/center - Dental | 27247 (Texas) | Secondary |
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