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General NPI Number Information
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NPI Number | 1033694187
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Entity Type | Organization
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Legal Business Name | RGT DENTAL CARE
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Dates
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Enumeration Date | 09/25/2018
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Last Update Date | 09/25/2018
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Provider Practice Location Address
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Address Line | 402 SIMONTON ST. SUITE 100
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City | CONROE
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State | TX
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Zip | 77301
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Country | US
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Telephone | 936-441-4455
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Fax | 888-678-1441
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Provider Business Mailing Address
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Address Line | 402 SIMONTON ST. SUITE 100
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City | CONROE
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State | TX
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Zip | 77301
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Country | US
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Telephone | 936-441-4455
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Fax | 888-678-1441
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERTO K. GILES
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Credential | DMD
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Telephone | 936-441-4455
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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 |
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License Number State |
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