Healthcare Provider Details

I. General information

NPI: 1740299452
Provider Name (Legal Business Name): DDS ASSOCIATES LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 09/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6550 FANNIN ST SUITE 2103
HOUSTON TX
77030-2717
US

IV. Provider business mailing address

6550 FANNIN ST SUITE 2103
HOUSTON TX
77030-2717
US

V. Phone/Fax

Practice location:
  • Phone: 713-797-0846
  • Fax: 713-797-1314
Mailing address:
  • Phone: 713-797-0846
  • Fax: 713-797-1314

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number8307
License Number StateTX

VIII. Authorized Official

Name: MRS. ANGELIQUE MONAE MANOVICH
Title or Position: MANAGER
Credential:
Phone: 713-797-0846