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General NPI Number Information
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NPI Number | 1821538810
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Entity Type | Organization
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Legal Business Name | ADVANCED PERIODONTICS AND IMPLANTS OF KATY
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Dates
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Enumeration Date | 02/24/2017
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Last Update Date | 02/24/2017
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Provider Practice Location Address
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Address Line | 25318 KINGSLAND BLVD
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City | KATY
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State | TX
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Zip | 77494-0000
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Country | US
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Telephone | 832-840-9560
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Fax |
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Provider Business Mailing Address
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Address Line | 25318 KINGSLAND BLVD
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City | KATY
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State | TX
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Zip | 77494-0000
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Country | US
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Telephone | 832-840-9560
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | JOSEPH WILLIAM HOLLAND III
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Credential | DDS, MSD
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Telephone | 409-718-7857
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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 | 29300
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License Number State | TX
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