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General NPI Number Information
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NPI Number | 1568955052
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Entity Type | Organization
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Legal Business Name | RM DENTAL PLLC
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Dates
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Enumeration Date | 06/11/2018
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 6500 NORTH FWY STE 124
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City | HOUSTON
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State | TX
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Zip | 77076-2941
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Country | US
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Telephone | 713-598-7596
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Fax |
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Provider Business Mailing Address
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Address Line | 1822 MCILHENNY ST # C
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City | HOUSTON
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State | TX
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Zip | 77004-1251
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Country | US
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Telephone | 713-598-7596
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. RYAN MANEEVESE
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Credential | DDS
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Telephone | 713-598-7596
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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 | 29915
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License Number State | TX
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