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General NPI Number Information
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NPI Number | 1003964214
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Entity Type | Organization
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Legal Business Name | ARCHANGEL DENTAL GROUP, P.A.
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Dates
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Enumeration Date | 01/07/2007
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Last Update Date | 11/18/2011
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Provider Practice Location Address
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Address Line | 10100 BEECHNUT ST SUITE 110
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City | HOUSTON
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State | TX
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Zip | 77072-5000
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Country | US
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Telephone | 281-879-5800
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Fax | 281-879-9300
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Provider Business Mailing Address
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Address Line | 10100 BEECHNUT ST STE 110
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City | HOUSTON
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State | TX
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Zip | 77072-5042
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Country | US
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Telephone | 281-879-5800
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Fax | 281-879-5858
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Authorized Official
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Title or Position | DENTIST
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Name | DR. CHARLES KAI CHOW
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Credential | D.D.S.
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Telephone | 281-879-5800
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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 | 20638
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License Number State | TX
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