| Uptown Park Dental | |
|
1121 Uptown Park Blvd Ste 19 Houston TX 77056-3226 | |
| (713) 621-4830 | |
| (713) 621-6261 |
| Full Name | Uptown Park Dental |
|---|---|
| Speciality | Dentist |
| Location | 1121 Uptown Park Blvd Ste 19, Houston, Texas |
| Authorized Official Name and Position | Dominique D Rodgers (PRACTICE ADMINSTRATOR) |
| Authorized Official Contact | 7136214830 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Uptown Park Dental 1121 Uptown Park Blvd Ste 19 Houston TX 77056-3226 Ph: (713) 621-4830 | Uptown Park Dental 1121 Uptown Park Blvd Ste 19 Houston TX 77056-3226 Ph: (713) 621-4830 |
| NPI Number | 1356730428 |
|---|---|
| Provider Enumeration Date | 01/13/2015 |
| Last Update Date | 01/13/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356730428 | NPI | - | NPPES |
| 24061 | Other | TX | DENTAL LICENSE |
| 1223G0001X | Other | TX | GENERAL DENTISTRY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 24061 (Texas) | Primary |
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