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General NPI Number Information
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NPI Number | 1508328899
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Entity Type | Organization
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Legal Business Name | ABIMBOLA OLUTIMEHIN, PLLC
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Dates
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Enumeration Date | 04/04/2019
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Last Update Date | 12/16/2019
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Provider Practice Location Address
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Address Line | 19433 MORRIS AVE STE. 120
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City | MANVEL
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State | TX
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Zip | 77578
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Country | US
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Telephone | 832-637-5085
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Fax |
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Provider Business Mailing Address
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Address Line | 19433 MORRIS AVE. STE. 120
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City | MANVEL
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State | TX
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Zip | 77578
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Country | US
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Telephone | 832-637-5085
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ABIMBOLA OLUTIMEHIN
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Credential | D.D.S.
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Telephone | 832-637-5085
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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