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4724 Sweetwater Blvd Ste 105 Sugar Land TX 77479 | |
| (281) 491-4545 | |
| (281) 491-7134 |
| Full Name | |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 4724 Sweetwater Blvd Ste 105, Sugar Land, Texas |
| Authorized Official Name and Position | Gina Casu (CREDENTIALING MANAGER) |
| Authorized Official Contact | 7137906477 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
4724 Sweetwater Blvd Ste 105 Sugar Land TX 77479-3150 Ph: (281) 491-4545 | 4724 Sweetwater Blvd Ste 105 Sugar Land TX 77479 Ph: (281) 491-4545 |
| NPI Number | 1003216250 |
|---|---|
| Provider Enumeration Date | 08/25/2014 |
| Last Update Date | 08/08/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003216250 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 30729 (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 |