MEDICARE: RL DENTAL VENTURES

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	:	1902563323
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RL DENTAL VENTURES

Provider Business Mailing Address
First Line	:	1800 BERING DR STE 650
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77057-3170
Country	:	US
Telephone Number	:	713-784-2952
Fax Number	:

Provider Business Practice Location Address
First Line	:	1800 BERING DR STE 650
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77057-3170
Country	:	US
Telephone Number	:	713-784-2952
Fax Number	:

Authorized Official
Title or Position	:	CEO AND PRESIDENT
Name	:	DR. NELSON REYNOLDS LAWNIN
Credential	:	DDS
Telephone Number	:	713-784-2952

Provider Enumeration Date	:	11/19/2021
Last Update Date	:	11/19/2021

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Directions to “RL DENTAL VENTURES ” Practice Location

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