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General NPI Number Information
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NPI Number | 1003443284
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Entity Type | Organization
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Legal Business Name | TRINITY SPRING DENTAL PLLC
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Dates
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Enumeration Date | 03/26/2020
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Last Update Date | 10/06/2020
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Provider Practice Location Address
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Address Line | 5240 FM 2920 RD STE 400
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City | SPRING
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State | TX
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Zip | 77388-3003
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Country | US
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Telephone | 832-648-7632
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Fax | 832-532-1904
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Provider Business Mailing Address
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Address Line | 507 N SAM HOUSTON PKWY E STE 565
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City | HOUSTON
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State | TX
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Zip | 77060-4021
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Country | US
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Telephone | 832-648-7632
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | RUBEN LOPEZ
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Credential | DO
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Telephone | 832-648-7632
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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