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General NPI Number Information
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NPI Number | 1518231133
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Entity Type | Organization
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Legal Business Name | MORAVEJ DENTAL CORPORATION
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Dates
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Enumeration Date | 02/29/2012
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Last Update Date | 09/06/2016
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Provider Practice Location Address
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Address Line | 902 FROSTWOOD DR SUITE # 166
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City | HOUSTON
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State | TX
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Zip | 77024-2420
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Country | US
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Telephone | 713-461-6161
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Fax | 713-461-4282
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Provider Business Mailing Address
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Address Line | 902 FROSTWOOD DR SUITE # 166
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City | HOUSTON
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State | TX
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Zip | 77024-2420
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Country | US
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Telephone | 713-461-6161
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Fax | 713-461-4282
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Authorized Official
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Title or Position | OWNER/ PRESIDENT
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Name | DR. ALBERT MORAVEJ
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Credential | D.D.S
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Telephone | 713-492-4142
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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 | 24364
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License Number State | TX
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