MEDICARE: SALLY ANN LANDON D.D.S.

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	122300000X	Dentist	18147	TX

General Provider Information

NPI Number	:	1972768851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SALLY ANN LANDON D.D.S.

Provider Business Mailing Address
First Line	:	3120 NASA PKWY
Second Line	:
City	:	SEABROOK
State	:	TX
Zip	:	77586-6465
Country	:	US
Telephone Number	:	281-326-7117
Fax Number	:

Provider Business Practice Location Address
First Line	:	3120 NASA PKWY
Second Line	:
City	:	SEABROOK
State	:	TX
Zip	:	77586-6465
Country	:	US
Telephone Number	:	281-326-7117
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2008
Last Update Date	:	03/31/2016

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Directions to “ SALLY ANN LANDON D.D.S.” Practice Location

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