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General NPI Number Information
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NPI Number | 1225421019
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Entity Type | Organization
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Legal Business Name | SEALY DENTISTRY - SEALY ENDO PLLC
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Dates
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Enumeration Date | 03/18/2015
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Last Update Date | 03/18/2015
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Provider Practice Location Address
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Address Line | 226 4TH ST
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City | SEALY
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State | TX
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Zip | 77474-2726
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Country | US
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Telephone | 979-987-1333
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Fax |
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Provider Business Mailing Address
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Address Line | 226 4TH ST
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City | SEALY
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State | TX
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Zip | 77474-2726
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Country | US
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Telephone | 979-987-1333
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | STEVE JAMES
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Credential |
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Telephone | 502-254-8504
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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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