| Southern Dental Associates - Pasadena | |
|
1213 Main St Pasadena TX 77506-4546 | |
| (713) 473-0583 | |
| (713) 473-7322 |
| Full Name | Southern Dental Associates - Pasadena |
|---|---|
| Speciality | Dentist |
| Location | 1213 Main St, Pasadena, Texas |
| Authorized Official Name and Position | David D. Lewis (PRESIDENT) |
| Authorized Official Contact | 7136817920 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Dental Associates - Pasadena 2500 Central Pkwy Suite P Houston TX 77092-7733 Ph: (713) 681-7920 | Southern Dental Associates - Pasadena 1213 Main St Pasadena TX 77506-4546 Ph: (713) 473-0583 |
| NPI Number | 1801802251 |
|---|---|
| Provider Enumeration Date | 07/31/2006 |
| Last Update Date | 08/14/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801802251 | NPI | - | NPPES |
| 136359012 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 9517 (Texas) | Primary |
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