Healthcare Provider Details

I. General information

NPI: 1942805015
Provider Name (Legal Business Name): KUVIS DENTAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2020
Last Update Date: 10/09/2024
Certification Date: 10/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10750 BARKER CYPRESS RD STE 111
CYPRESS TX
77433-2282
US

IV. Provider business mailing address

10750 BARKER CYPRESS RD STE 111
CYPRESS TX
77433-2282
US

V. Phone/Fax

Practice location:
  • Phone: 281-213-8666
  • Fax:
Mailing address:
  • Phone: 281-213-8666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number StateNULL

VIII. Authorized Official

Name: KRYSTLE EGO UDEZUE
Title or Position: PRESIDENT
Credential:
Phone: 281-213-8666