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General NPI Number Information
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NPI Number | 1922733468
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Entity Type | Organization
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Legal Business Name | CES DENTAL ENTERPRISE PLLC
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Dates
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Enumeration Date | 07/19/2022
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Last Update Date | 04/11/2023
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Provider Practice Location Address
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Address Line | 13649 EASTLAKE BLVD STE E2 AND E3
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City | HORIZON CITY
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State | TX
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Zip | 79928
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Country | US
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Telephone | 915-235-0110
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Fax |
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Provider Business Mailing Address
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Address Line | 19038 YELLOWSTONE LANDING CT
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City | CYPRESS
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State | TX
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Zip | 77433-8132
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Country | US
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Telephone | 915-235-0110
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Fax |
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Authorized Official
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Title or Position | DOCTOR/OWNER
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Name | DR. JOSE MILTON HERNANDEZ MERCADO
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Credential | DMD
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Telephone | 713-754-0249
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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 |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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