MEDICARE: PRESTON L. WEST, DDS PC

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	:	1568933489
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRESTON L. WEST, DDS PC

Provider Business Mailing Address
First Line	:	831 FROSTWOOD DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77024-4131
Country	:	US
Telephone Number	:	713-467-3889
Fax Number	:	713-467-3931

Provider Business Practice Location Address
First Line	:	831 FROSTWOOD DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77024-4131
Country	:	US
Telephone Number	:	713-467-3889
Fax Number	:	713-467-3931

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. PRESTON L. WEST
Credential	:	DDS
Telephone Number	:	713-467-3889

Provider Enumeration Date	:	12/17/2018
Last Update Date	:	12/17/2018

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