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2400 Mid Ln Ste 350 Houston TX 77027-4466 | |
| (713) 714-4245 | |
| (713) 714-4245 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2400 Mid Ln Ste 350, Houston, Texas |
| Authorized Official Name and Position | Julia Rivas (COO) |
| Authorized Official Contact | 7137144245 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2400 Mid Ln Ste 350 Houston TX 77027-4466 Ph: (713) 714-4245 | 2400 Mid Ln Ste 350 Houston TX 77027-4466 Ph: (713) 714-4245 |
| NPI Number | 1174033054 |
|---|---|
| Provider Enumeration Date | 10/05/2017 |
| Last Update Date | 01/26/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174033054 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 30398 (Texas) | Primary |
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