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NPI Code Detail

MEDICARE: GROVEWAY DENTAL ASSOCIATES

MEDICARE: GROVEWAY DENTAL ASSOCIATES
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
1122300000XDentist16907TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1265694657
Entity Type Code : Organization
Provider Name (Legal Business Name) : GROVEWAY DENTAL ASSOCIATES
Provider Business Mailing Address
First Line : 4501 GROVEWAY DR
Second Line :
City : HOUSTON
State : TX
Zip : 77087-1122
Country : US
Telephone Number : 713-641-1118
Fax Number : 713-640-2221
Provider Business Practice Location Address
First Line : 4501 GROVEWAY DR
Second Line :
City : HOUSTON
State : TX
Zip : 77087-1122
Country : US
Telephone Number : 713-641-1118
Fax Number : 713-640-2221
Authorized Official
Title or Position : DENTIST
Name : DR. SELMA B GUTTIN
Credential :
Telephone Number : 713-641-1118
Provider Enumeration Date : 06/27/2008
Last Update Date : 06/27/2008

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Directions to “GROVEWAY DENTAL ASSOCIATES ” Practice Location

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