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General NPI Number Information
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NPI Number | 1649264102
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Entity Type | Organization
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Legal Business Name | FULTON DENTAL ASSOCIATES, PA
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Dates
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Enumeration Date | 09/09/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2445 FULTON ST SUITE #B
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City | HOUSTON
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State | TX
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Zip | 77009-7837
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Country | US
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Telephone | 713-225-2266
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Fax | 713-225-2275
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Provider Business Mailing Address
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Address Line | 2445 FULTON ST SUITE #B
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City | HOUSTON
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State | TX
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Zip | 77009-7837
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Country | US
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Telephone | 713-225-2266
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Fax | 713-225-2275
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Authorized Official
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Title or Position | OWNER
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Name | SHANNON DENISE PRESLEY
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Credential | D.D.S.
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Telephone | 713-225-2266
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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 |
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License Number State |
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