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General NPI Number Information
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NPI Number | 1205512704
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Entity Type | Organization
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Legal Business Name | TUSK DENTAL GROUP INC
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Dates
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Enumeration Date | 06/27/2023
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Last Update Date | 06/27/2023
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Provider Practice Location Address
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Address Line | 11625 BROADWAY ST STE 185
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City | PEARLAND
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State | TX
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Zip | 77584-3937
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Country | US
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Telephone | 713-955-4224
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Fax | 713-955-4399
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Provider Business Mailing Address
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Address Line | 1901 POST OAK BLVD #2108
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City | HOUSTON
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State | TX
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Zip | 77056
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Country | US
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Telephone | 214-882-6874
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Fax | 214-276-7500
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. CHRISTOPHER W MCGARRY
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Credential |
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Telephone | 214-882-6874
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 126800000X
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Taxonomy Name | Dental Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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Taxonomy #5
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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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Taxonomy #6
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 126900000X
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Taxonomy Name | Dental Laboratory Technician
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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