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General NPI Number Information
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NPI Number | 1699588632
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Entity Type | Organization
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Legal Business Name | P.S DENTISTRY, PLLC
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Dates
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Enumeration Date | 01/31/2025
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Last Update Date | 01/31/2025
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Provider Practice Location Address
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Address Line | 2506 JORDAN RANCH BLVD. SUITE 6
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City | BROOKSHIRE
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State | TX
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Zip | 77423
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Country | US
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Telephone | 847-848-4824
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Fax |
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Provider Business Mailing Address
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Address Line | 11210 PUCKETT RIVER DR
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City | CYPRESS
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State | TX
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Zip | 77433-0237
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Country | US
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Telephone | 847-848-4824
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Fax |
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Authorized Official
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Title or Position | DMD
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Name | RADHWAN AL SINAWI
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Credential |
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Telephone | 847-848-4824
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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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