MEDICARE: FEBRES DENTISTRY FOR CHILDREN

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	1223P0221X	Pediatric Dentistry	20661	TX

General Provider Information

NPI Number	:	1144437872
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FEBRES DENTISTRY FOR CHILDREN

Provider Business Mailing Address
First Line	:	2000 S DAIRY ASHFORD ST
Second Line	:	SUITE 530
City	:	HOUSTON
State	:	TX
Zip	:	77077-5700
Country	:	US
Telephone Number	:	281-597-0404
Fax Number	:	281-597-0430

Provider Business Practice Location Address
First Line	:	2000 S DAIRY ASHFORD ST
Second Line	:	SUITE 530
City	:	HOUSTON
State	:	TX
Zip	:	77077-5700
Country	:	US
Telephone Number	:	281-597-0404
Fax Number	:	281-597-0430

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. MARIA CAROLINA FEBRES
Credential	:	DDS
Telephone Number	:	281-597-0404

Provider Enumeration Date	:	05/16/2007
Last Update Date	:	08/21/2007

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