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General NPI Number Information
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NPI Number | 1902278484
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Entity Type | Organization
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Legal Business Name | ASSOCIATES FOR DENTAL HEALTH, PLLC.
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Dates
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Enumeration Date | 10/23/2015
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Last Update Date | 10/23/2015
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Provider Practice Location Address
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Address Line | 5712 KIRBY DR
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City | HOUSTON
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State | TX
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Zip | 77005-2408
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Country | US
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Telephone | 281-738-1579
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Fax | 713-490-6464
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Provider Business Mailing Address
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Address Line | 6137 KIRBY DR
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City | HOUSTON
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State | TX
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Zip | 77005-3148
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Country | US
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Telephone | 281-738-1579
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Fax | 713-490-6464
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Authorized Official
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Title or Position | OWNER
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Name | DONAL WAYNE ANDRESS
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Credential | DDS
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Telephone | 281-738-1579
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 6626
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 6626
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License Number State | TX
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