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General NPI Number Information
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NPI Number | 1316090970
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Entity Type | Organization
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Legal Business Name | FAMILY DENTAL CENTER INC
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4000 FULTON ST
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City | HOUSTON
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State | TX
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Zip | 77009-4729
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Country | US
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Telephone | 713-692-2627
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Fax |
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Provider Business Mailing Address
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Address Line | 4000 FULTON ST
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City | HOUSTON
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State | TX
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Zip | 77009-4729
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Country | US
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Telephone | 713-692-2627
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Fax |
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Authorized Official
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Title or Position | SECRETARY
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Name | MRS. ROSARIO D GARZA
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Credential | DENTIST
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Telephone | 713-692-2627
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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 | 17797
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License Number State | TX
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