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General NPI Number Information
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NPI Number | 1235374786
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Entity Type | Organization
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Legal Business Name | WESTWOOD DENTAL GROUP
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Dates
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Enumeration Date | 12/12/2008
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Last Update Date | 12/12/2008
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Provider Practice Location Address
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Address Line | 14039 WESTHEIMER RD
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City | HOUSTON
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State | TX
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Zip | 77077-5360
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Country | US
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Telephone | 281-558-3384
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Fax | 713-722-8441
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Provider Business Mailing Address
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Address Line | 1458 CAMPBELL RD STE 200
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City | HOUSTON
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State | TX
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Zip | 77055-4669
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Country | US
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Telephone | 713-722-8400
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Fax | 713-722-8441
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Authorized Official
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Title or Position | OWNER
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Name | DR. EDWARD W RUSSEY JR.
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Credential | DDS
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Telephone | 713-722-8400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 5820
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License Number State | TX
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