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General NPI Number Information
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NPI Number | 1912212259
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Entity Type | Organization
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Legal Business Name | SEVEN MEADOWS DENTAL
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Dates
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Enumeration Date | 08/11/2010
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Last Update Date | 08/11/2010
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Provider Practice Location Address
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Address Line | 23108 SEVEN MEADOWS PKWY STE 200
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City | KATY
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State | TX
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Zip | 77494-0256
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Country | US
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Telephone | 281-693-0475
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Fax | 281-693-0479
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Provider Business Mailing Address
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Address Line | 23108 SEVEN MEADOWS PKWY STE 200
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City | KATY
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State | TX
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Zip | 77494-0256
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Country | US
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Telephone | 281-693-0475
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Fax | 281-693-0479
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AMY C FILLMAN
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Credential | D.D.S.
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Telephone | 281-693-0475
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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 | 21296
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License Number State | TX
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