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General NPI Number Information
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NPI Number | 1003247065
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Entity Type | Organization
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Legal Business Name | ESTEEM DENTAL NORTH PARK
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Dates
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Enumeration Date | 12/02/2013
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Last Update Date | 12/02/2013
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Provider Practice Location Address
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Address Line | 25653 US HIGHWAY 59 N STE 207
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City | KINGWOOD
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State | TX
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Zip | 77339
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Country | US
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Telephone | 832-463-4411
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 84703
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City | PEARLAND
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State | TX
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Zip | 77584-0010
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Country | US
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Telephone | 832-463-4411
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | ROBERT LEE
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Credential | D.D.S
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Telephone | 832-349-6286
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 25844
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License Number State | TX
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