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6455 S Shore Blvd Ste 100 League City TX 77573-5525 | |
| (281) 334-5354 | |
| (281) 334-5344 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 6455 S Shore Blvd Ste 100, League City, Texas |
| Authorized Official Name and Position | Amanda G Hoover (PRESIDENT) |
| Authorized Official Contact | 2813345354 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
6455 S Shore Blvd Ste 100 League City TX 77573-5525 Ph: (281) 334-5354 | 6455 S Shore Blvd Ste 100 League City TX 77573-5525 Ph: (281) 334-5354 |
| NPI Number | 1235368150 |
|---|---|
| Provider Enumeration Date | 07/13/2009 |
| Last Update Date | 07/13/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235368150 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 21338 (Texas) | Primary |
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