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6611 Fm 1464 Rd Ste D Richmond TX 77407-8222 | |
| (713) 480-1448 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 6611 Fm 1464 Rd Ste D, Richmond, Texas |
| Authorized Official Name and Position | Rotunda Dotson (BILLING COORDINATOR) |
| Authorized Official Contact | 2815131509 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
6611 Fm 1464 Rd Ste D Richmond TX 77407-8222 Ph: (713) 480-1448 | 6611 Fm 1464 Rd Ste D Richmond TX 77407-8222 Ph: (713) 480-1448 |
| NPI Number | 1992296578 |
|---|---|
| Provider Enumeration Date | 05/20/2018 |
| Last Update Date | 05/20/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992296578 | NPI | - | NPPES |
| 28109 | Other | TX | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 28109 (Texas) | Primary |
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