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General NPI Number Information
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NPI Number | 1043750664
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Entity Type | Organization
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Legal Business Name | MICHAEL NUGENT DDS PC
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Dates
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Enumeration Date | 03/01/2017
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Last Update Date | 03/01/2017
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Provider Practice Location Address
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Address Line | 3421 BURKE RD SUITE A
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City | PASADENA
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State | TX
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Zip | 77504-1975
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Country | US
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Telephone | 713-941-8261
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Fax | 888-293-4807
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Provider Business Mailing Address
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Address Line | 3421 BURKE RD SUITE A
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City | PASADENA
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State | TX
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Zip | 77504-1975
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Country | US
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Telephone | 713-941-8261
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Fax | 888-293-4807
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. LISA HOKANSON
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Credential |
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Telephone | 713-941-8261
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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 | 22464
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License Number State | TX
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