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General NPI Number Information
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NPI Number | 1669841128
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Entity Type | Organization
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Legal Business Name | ENERGY DENTAL PLLC
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Dates
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Enumeration Date | 09/15/2015
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Last Update Date | 09/15/2015
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Provider Practice Location Address
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Address Line | 1398 ELDRIDGE PKWY SUITE 220
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City | HOUSTON
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State | TX
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Zip | 77077-2547
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Country | US
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Telephone | 281-496-7493
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Fax | 281-929-0473
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Provider Business Mailing Address
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Address Line | 1398 ELDRIDGE PKWY SUITE 220
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City | HOUSTON
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State | TX
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Zip | 77077-2547
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Country | US
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Telephone | 281-496-7493
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Fax | 281-929-0473
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | DR. EMILY LE-SAAB
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Credential | DDS
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Telephone | 281-496-7493
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 22808
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License Number State | TX
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