MEDICARE: ANCHOR DENTAL, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1053629196
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANCHOR DENTAL, P.C.

Provider Business Mailing Address
First Line	:	16603 ROSE VIEW CT
Second Line	:
City	:	CYPRESS
State	:	TX
Zip	:	77429-3685
Country	:	US
Telephone Number	:	512-619-5590
Fax Number	:	512-857-1076

Provider Business Practice Location Address
First Line	:	830 S MASON RD STE A6
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77450-3863
Country	:	US
Telephone Number	:	512-619-5590
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	KIMBERLEY FRANEK
Credential	:
Telephone Number	:	512-619-5590

Provider Enumeration Date	:	09/23/2010
Last Update Date	:	09/23/2010

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