| Premier Dental Club Pc | |
|
9720 Cypresswood Dr Ste 200 Houston TX 77070-3357 | |
| (346) 296-9056 | |
| (346) 501-4160 |
| Full Name | Premier Dental Club Pc |
|---|---|
| Speciality | Dentist |
| Location | 9720 Cypresswood Dr Ste 200, Houston, Texas |
| Authorized Official Name and Position | Bethel Ozumba (OWNER) |
| Authorized Official Contact | 8327049852 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Dental Club Pc 9720 Cypresswood Dr Ste 200 Houston TX 77070-3357 Ph: (346) 296-9056 | Premier Dental Club Pc 9720 Cypresswood Dr Ste 200 Houston TX 77070-3357 Ph: (346) 296-9056 |
| NPI Number | 1851025118 |
|---|---|
| Provider Enumeration Date | 07/13/2022 |
| Last Update Date | 12/05/2022 |
| Medicare PECOS PAC ID | 3375915564 |
|---|---|
| Medicare Enrollment ID | O20230216002264 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851025118 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
| Provider Name | Bethel Ozumba |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1720606940 PECOS PAC ID: 4284006479 Enrollment ID: I20230216002442 |
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