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General NPI Number Information
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NPI Number | 1053571489
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Entity Type | Organization
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Legal Business Name | ALBERT A ALFONSO DDS PA
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Dates
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Enumeration Date | 06/10/2008
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Last Update Date | 06/10/2008
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Provider Practice Location Address
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Address Line | 10926 GRANT RD
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City | HOUSTON
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State | TX
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Zip | 77070-4445
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Country | US
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Telephone | 281-807-6555
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Fax | 281-469-5907
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Provider Business Mailing Address
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Address Line | 10926 GRANT RD
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City | HOUSTON
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State | TX
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Zip | 77070-4445
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Country | US
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Telephone | 281-807-6555
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Fax | 281-469-5907
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Authorized Official
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Title or Position | OWNER
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Name | DR. ALBERT A ALFONSO
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Credential | DDS
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Telephone | 281-807-6555
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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 | 20647
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License Number State | TX
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