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General NPI Number Information
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NPI Number | 1174355747
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Entity Type | Organization
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Legal Business Name | GLC DENTAL PLLC
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Dates
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Enumeration Date | 08/14/2024
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Last Update Date | 09/04/2024
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Provider Practice Location Address
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Address Line | 8145 HIGHWAY 6 BUILDING B #200
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City | MISSOURI CITY
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State | TX
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Zip | 77459-3897
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Country | US
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Telephone | 832-930-7842
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Fax |
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Provider Business Mailing Address
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Address Line | 2000 WEST LOOP S STE 1330
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City | HOUSTON
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State | TX
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Zip | 77027-3513
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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 | KATIA RODRIGUEZ
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Credential |
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Telephone | 832-930-7842
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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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