MEDICARE: QUEST DENTISTRY 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	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1952815821
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUEST DENTISTRY PC

Provider Business Mailing Address
First Line	:	4835 HIGHWAY 6 N
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77084-2716
Country	:	US
Telephone Number	:	281-463-9324
Fax Number	:	281-238-5978

Provider Business Practice Location Address
First Line	:	4835 HIGHWAY 6 N
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77084-2716
Country	:	US
Telephone Number	:	281-463-9324
Fax Number	:	281-238-5978

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MARY K TA
Credential	:	DDS
Telephone Number	:	281-463-9324

Provider Enumeration Date	:	11/29/2017
Last Update Date	:	03/27/2019

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Directions to “QUEST DENTISTRY PC ” Practice Location

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