MEDICARE: DR. ADELINA PABLOS MONTY D.D.S.

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	122300000X	Dentist	18185	TX

General Provider Information

NPI Number	:	1285823104
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADELINA PABLOS MONTY D.D.S.

Provider Business Mailing Address
First Line	:	150 W PARKER RD
Second Line	:	SUITE 702
City	:	HOUSTON
State	:	TX
Zip	:	77076-2951
Country	:	US
Telephone Number	:	713-691-1188
Fax Number	:	713-691-1196

Provider Business Practice Location Address
First Line	:	150 W PARKER RD
Second Line	:	SUITE 702
City	:	HOUSTON
State	:	TX
Zip	:	77076-2951
Country	:	US
Telephone Number	:	713-691-1188
Fax Number	:	713-691-1196

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/16/2007
Last Update Date	:	11/05/2010

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