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General NPI Number Information
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NPI Number | 1376656249
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Entity Type | Organization
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Legal Business Name | DOWNTOWN DENTAL ASSOCIATES
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Dates
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Enumeration Date | 08/16/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 808 TRAVIS ST STE T60
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City | HOUSTON
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State | TX
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Zip | 77002-5760
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Country | US
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Telephone | 713-227-5757
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Fax | 713-225-1844
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Provider Business Mailing Address
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Address Line | 808 TRAVIS ST STE T60
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City | HOUSTON
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State | TX
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Zip | 77002-5760
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Country | US
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Telephone | 713-227-5757
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Fax | 713-225-1844
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | MRS. MIRIAM JANE FOLTA
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Credential | DMD
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Telephone | 713-227-5757
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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 | 11970
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License Number State | TX
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