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General NPI Number Information
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NPI Number | 1790140614
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Entity Type | Organization
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Legal Business Name | GE DENTAL PLLC
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Dates
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Enumeration Date | 12/18/2015
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Last Update Date | 12/18/2015
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Provider Practice Location Address
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Address Line | 15103 MASON RD STE B-8
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City | CYPRESS
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State | TX
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Zip | 77433-6752
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Country | US
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Telephone | 281-712-2964
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Fax |
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Provider Business Mailing Address
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Address Line | 15103 MASON RD STE B-8
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City | CYPRESS
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State | TX
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Zip | 77433-6752
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. PIERRE GHATTAS
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Credential | D.D.S
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Telephone | 281-712-2964
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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 | 22621
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License Number State | TX
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