Healthcare Provider Details

I. General information

NPI: 1760866420
Provider Name (Legal Business Name): ASSOCIATES FOR DENTAL HEALTH, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2015
Last Update Date: 07/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4701 AIRLINE DR
HOUSTON TX
77022-3003
US

IV. Provider business mailing address

4701 AIRLINE DR
HOUSTON TX
77022-3003
US

V. Phone/Fax

Practice location:
  • Phone: 281-738-1579
  • Fax: 713-490-6464
Mailing address:
  • Phone: 281-738-1579
  • Fax: 713-490-8880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number6626
License Number State
# 7
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number6626
License Number StateTX

VIII. Authorized Official

Name: DONALD ANDRESS
Title or Position: OWNER
Credential: DDS
Phone: 281-738-1579