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General NPI Number Information
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NPI Number | 1295334803
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Entity Type | Organization
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Legal Business Name | JPM DENTAL, PLLC
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Dates
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Enumeration Date | 10/23/2020
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Last Update Date | 10/18/2021
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Provider Practice Location Address
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Address Line | 6915 FM 1960 RD W STE G
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City | HOUSTON
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State | TX
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Zip | 77069-3701
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Country | US
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Telephone | 713-385-3019
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Fax |
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Provider Business Mailing Address
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Address Line | 17723 LUMINAIRE LN
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City | RICHMOND
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State | TX
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Zip | 77407-7932
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Country | US
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Telephone | 713-375-3019
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. PRANAV MODY
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Credential | DDS
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Telephone | 713-385-3019
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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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