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NPI Code Detail

MEDICARE: DD CITYCENTRE HOLDINGS PLLC

MEDICARE: DD CITYCENTRE HOLDINGS PLLC
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
11223G0001XGeneral Practice Dentistry30398TX

General Provider Information

NPI Number : 1174033054
Entity Type Code : Organization
Provider Name (Legal Business Name) : DD CITYCENTRE HOLDINGS PLLC
Provider Business Mailing Address
First Line : 2400 MID LN STE 350
Second Line :
City : HOUSTON
State : TX
Zip : 77027-4466
Country : US
Telephone Number : 713-714-4245
Fax Number :
Provider Business Practice Location Address
First Line : 2400 MID LN STE 350
Second Line :
City : HOUSTON
State : TX
Zip : 77027-4466
Country : US
Telephone Number : 713-714-4245
Fax Number : 713-714-4245
Authorized Official
Title or Position : COO
Name : JULIA RIVAS
Credential :
Telephone Number : 713-714-4245
Provider Enumeration Date : 10/05/2017
Last Update Date : 01/26/2024

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Directions to “DD CITYCENTRE HOLDINGS PLLC ” Practice Location

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