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General NPI Number Information
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NPI Number | 1982931556
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Entity Type | Organization
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Legal Business Name | CISNEROS DENTISTRY
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Dates
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Enumeration Date | 11/03/2009
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Last Update Date | 11/03/2009
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Provider Practice Location Address
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Address Line | 1313 HOLLAND ST STE E
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City | HOUSTON
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State | TX
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Zip | 77029-2873
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Country | US
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Telephone | 713-450-2900
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Fax | 713-453-2479
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Provider Business Mailing Address
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Address Line | 1313 HOLLAND ST STE E
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City | HOUSTON
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State | TX
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Zip | 77029-2873
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Country | US
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Telephone | 713-450-2900
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Fax | 713-453-2479
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Authorized Official
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Title or Position | OWNER
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Name | VICTORIA Q. CISNEROS
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Credential |
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Telephone | 713-450-2900
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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 | 22148
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License Number State | TX
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