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General NPI Number Information
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NPI Number | 1427055292
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Entity Type | Organization
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Legal Business Name | PERIO HEALTH PROFESSIONALS, PLLC
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3400 S GESSNER RD SUITE 102
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City | HOUSTON
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State | TX
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Zip | 77063-7247
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Country | US
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Telephone | 713-783-5442
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Fax | 713-952-0614
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Provider Business Mailing Address
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Address Line | 3400 S GESSNER RD SUITE 102
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City | HOUSTON
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State | TX
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Zip | 77063-7247
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Country | US
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Telephone | 713-783-5442
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Fax | 713-952-0614
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Authorized Official
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Title or Position | OWNER/PARTNER
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Name | DR. MICHAEL KENT MCGUIRE
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Credential | D.D.S.
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Telephone | 713-783-5442
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 20405
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 11568
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License Number State | TX
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