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General NPI Number Information
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NPI Number | 1174220537
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Entity Type | Organization
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Legal Business Name | KS2 DENTAL PLLC
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Dates
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Enumeration Date | 02/15/2023
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Last Update Date | 03/28/2023
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Provider Practice Location Address
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Address Line | 6228 BROADWAY ST STE O
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City | GALVESTON
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State | TX
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Zip | 77551-1093
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Country | US
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Telephone | 575-218-9337
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Fax |
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Provider Business Mailing Address
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Address Line | 2221 DOVE HAVEN LN
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City | LEAGUE CITY
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State | TX
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Zip | 77573-4182
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | VANESSA ESPINOZA
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Credential |
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Telephone | 281-832-1368
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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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