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General NPI Number Information
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NPI Number | 1356566178
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Entity Type | Organization
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Legal Business Name | MUSEUM DISTRICT DENTAL SPECIALISTS, P.A.
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Dates
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Enumeration Date | 04/16/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1200 BINZ ST SUITE 1380
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City | HOUSTON
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State | TX
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Zip | 77004-6900
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Country | US
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Telephone | 713-520-8400
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Fax | 713-520-7999
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Provider Business Mailing Address
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Address Line | 1200 BINZ ST SUITE 1380
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City | HOUSTON
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State | TX
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Zip | 77004-6900
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Country | US
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Telephone | 713-520-8400
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Fax | 713-520-7999
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. DANIELA U ADEOLA
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Credential | DDS., MS
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Telephone | 713-520-8400
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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 | 22078
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License Number State | TX
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