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General NPI Number Information
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NPI Number | 1962783100
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Entity Type | Organization
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Legal Business Name | ADVANTAGE DENTISTS PASADENA, PLLC
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Dates
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Enumeration Date | 09/01/2011
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Last Update Date | 09/01/2011
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Provider Practice Location Address
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Address Line | 1501 PASADENA BLVD
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City | PASADENA
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State | TX
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Zip | 77502-2434
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Country | US
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Telephone | 832-336-8478
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Fax |
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Provider Business Mailing Address
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Address Line | 6818 ATASCOCITA RD
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City | HUMBLE
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State | TX
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Zip | 77346-2817
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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 | CO-OWNER; DENTIST
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Name | DR. DAVID UMANSKY
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Credential |
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Telephone | 832-336-8478
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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 | 20839
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License Number State | TX
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