MEDICARE: ESTEEM DENTAL PLLC

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	1223G0001X	General Practice Dentistry	25844	TX

General Provider Information

NPI Number	:	1417394263
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ESTEEM DENTAL PLLC

Provider Business Mailing Address
First Line	:	5810 E SAM HOUSTON PKWY N
Second Line	:	STE L
City	:	HOUSTON
State	:	TX
Zip	:	77049-2528
Country	:	US
Telephone Number	:	281-459-1541
Fax Number	:

Provider Business Practice Location Address
First Line	:	5810 E SAM HOUSTON PKWY N
Second Line	:	STE L
City	:	HOUSTON
State	:	TX
Zip	:	77049-2528
Country	:	US
Telephone Number	:	281-459-1541
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ROB J LEE
Credential	:	D.D.S
Telephone Number	:	281-459-1541

Provider Enumeration Date	:	06/03/2013
Last Update Date	:	06/03/2013

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