Healthcare Provider Details

I. General information

NPI: 1376928267
Provider Name (Legal Business Name): SPRING KLEIN DENTAL SPECIALISTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2015
Last Update Date: 07/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6078 FM 2920 RD
SPRING TX
77379-2542
US

IV. Provider business mailing address

6078 FM 2920 RD
SPRING TX
77379-2542
US

V. Phone/Fax

Practice location:
  • Phone: 832-709-0198
  • Fax: 832-827-4188
Mailing address:
  • Phone: 832-709-0198
  • Fax: 832-827-4188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number30839
License Number StateTX

VIII. Authorized Official

Name: DR. BERNARDO SARMIENTO JR.
Title or Position: ENDODONTIST
Credential: DDS
Phone: 832-709-0198