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955 Dairy Ashford St Suite 107 Houston TX 77079-5310 | |
| (281) 531-7000 | |
| (281) 531-7023 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 955 Dairy Ashford St, Houston, Texas |
| Authorized Official Name and Position | Mary Boney (DIR HR/PROFESSIONAL RELATIONS) |
| Authorized Official Contact | 2812968600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
26615 Oak Ridge Dr The Woodlands TX 77380-1968 Ph: (281) 296-8600 | 955 Dairy Ashford St Suite 107 Houston TX 77079-5310 Ph: (281) 531-7000 |
| NPI Number | 1104939198 |
|---|---|
| Provider Enumeration Date | 08/16/2006 |
| Last Update Date | 08/20/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104939198 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (Texas) | Primary |
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