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General NPI Number Information
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NPI Number | 1760987424
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Entity Type | Organization
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Legal Business Name | PASADENA DENTAL CARE
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Dates
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Enumeration Date | 03/26/2018
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Last Update Date | 03/26/2018
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Provider Practice Location Address
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Address Line | 1501 PASADENA BLVD
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City | PASADENA
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State | TX
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Zip | 77502-2434
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Country | US
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Telephone | 832-648-7900
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Fax |
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Provider Business Mailing Address
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Address Line | 1501 PASADENA BLVD
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City | PASADENA
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State | TX
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Zip | 77502-2434
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Country | US
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Telephone | 832-648-7900
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | KIM VU
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Credential |
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Telephone | 713-261-0100
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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 |
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License Number State |
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