MEDICARE: ALDO SORDELLI DDS, MSD, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1063546653
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALDO SORDELLI DDS, MSD, PA

Provider Business Mailing Address
First Line	:	1035 DAIRY ASHFORD ST
Second Line	:	#234
City	:	HOUSTON
State	:	TX
Zip	:	77079-4608
Country	:	US
Telephone Number	:	281-759-2929
Fax Number	:	281-759-0907

Provider Business Practice Location Address
First Line	:	1035 DAIRY ASHFORD ST
Second Line	:	#234
City	:	HOUSTON
State	:	TX
Zip	:	77079-4608
Country	:	US
Telephone Number	:	281-759-2929
Fax Number	:	281-759-0907

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ALDO SORDELLI
Credential	:	DDS, MSD
Telephone Number	:	281-759-2929

Provider Enumeration Date	:	03/15/2007
Last Update Date	:	09/24/2007

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