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General NPI Number Information
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NPI Number | 1043842156
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Entity Type | Organization
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Legal Business Name | CHAMPIONS DENTISTRY PA
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Dates
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Enumeration Date | 02/06/2020
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Last Update Date | 02/06/2020
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Provider Practice Location Address
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Address Line | 8419 LOUETTA RD STE A
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City | SPRING
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State | TX
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Zip | 77379-6737
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Country | US
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Telephone | 281-401-8200
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Fax | 281-401-8201
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Provider Business Mailing Address
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Address Line | 8419 LOUETTA RD STE A
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City | SPRING
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State | TX
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Zip | 77379-6737
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Country | US
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Telephone | 281-401-8200
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Fax | 281-401-8201
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Authorized Official
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Title or Position | FINANCIAL COORDINATOR
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Name | KAY HAGGARD
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Credential | OFFICCE STAFF
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Telephone | 281-401-8200
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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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