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General NPI Number Information
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NPI Number | 1306159280
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Entity Type | Organization
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Legal Business Name | TAMBORELLO DENTAL P.L.L.C.
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Dates
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Enumeration Date | 07/20/2010
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Last Update Date | 08/29/2018
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Provider Practice Location Address
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Address Line | 2150 RICHMOND AVE STE 100
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City | HOUSTON
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State | TX
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Zip | 77098-3327
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Country | US
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Telephone | 713-522-7540
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Fax | 713-522-7664
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Provider Business Mailing Address
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Address Line | 2150 RICHMOND AVE STE 100
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City | HOUSTON
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State | TX
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Zip | 77098-3327
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Country | US
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Telephone | 713-522-7540
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Fax | 713-522-7664
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Authorized Official
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Title or Position | DENTIST
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Name | DONALD F TAMBORELLO
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Credential | D.D.S.
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Telephone | 713-522-7540
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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 | 14371
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 20865
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License Number State | TX
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