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General NPI Number Information
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NPI Number | 1326222530
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Entity Type | Organization
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Legal Business Name | MOTA DENTAL PC
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Dates
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Enumeration Date | 12/24/2007
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Last Update Date | 12/24/2007
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Provider Practice Location Address
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Address Line | 550 KATY FORT BEND RD SUITE #100
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City | KATY
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State | TX
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Zip | 77494
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Country | US
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Telephone | 281-574-2460
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Fax | 281-574-2466
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Provider Business Mailing Address
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Address Line | 550 KATY FORT BEND RD SUITE #100
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City | KATY
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State | TX
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Zip | 77494
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Country | US
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Telephone | 281-574-2460
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Fax | 281-574-2466
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Authorized Official
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Title or Position | OWNER
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Name | DR. ISELSA J MOTA
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Credential |
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Telephone | 832-274-9065
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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 | 21087
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License Number State | TX
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