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General NPI Number Information
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NPI Number | 1073482030
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Entity Type | Organization
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Legal Business Name | CONROE DENTAL CENTER PLLC
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Dates
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Enumeration Date | 10/30/2025
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 2210 N FRAZIER ST STE 120
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City | CONROE
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State | TX
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Zip | 77303-1701
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Country | US
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Telephone | 936-242-0319
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Fax |
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Provider Business Mailing Address
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Address Line | 2109 COMMERCE ST STE 200
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City | DALLAS
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State | TX
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Zip | 75201-4350
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Country | US
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Telephone | 972-248-1221
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Fax |
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Authorized Official
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Title or Position | OWNER, DENTIST
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Name | WILLIAM ROBERT JENNINGS
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Credential | DDS
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Telephone | 940-206-8959
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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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