Healthcare Provider Details
I. General information
NPI: 1346589561
Provider Name (Legal Business Name): SPRING ENDODONTICS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/07/2013
Last Update Date: 02/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
525 SAWDUST RD # 107
SPRING TX
77380-2385
US
IV. Provider business mailing address
525 SAWDUST RD # 107
SPRING TX
77380-2385
US
V. Phone/Fax
- Phone: 281-203-0503
- Fax: 281-203-0563
- Phone: 281-203-0503
- Fax: 281-203-0563
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223E0200X |
| Taxonomy | Endodontics |
| License Number | |
| License Number State | TX |
VIII. Authorized Official
Name: MR.
SHIWEI
CAI
Title or Position: OWNER
Credential: DDS, MSD,MS,PHD
Phone: 713-806-0264