MEDICARE: ARCH DENTAL PC

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	1223G0001X	General Practice Dentistry	24530	TX

General Provider Information

NPI Number	:	1336469626
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARCH DENTAL PC

Provider Business Mailing Address
First Line	:	9816 MEMORIAL BLVD
Second Line	:	SUITE 101
City	:	HUMBLE
State	:	TX
Zip	:	77338-4255
Country	:	US
Telephone Number	:	281-446-6527
Fax Number	:

Provider Business Practice Location Address
First Line	:	9816 MEMORIAL BLVD
Second Line	:	SUITE 101
City	:	HUMBLE
State	:	TX
Zip	:	77338-4255
Country	:	US
Telephone Number	:	281-446-6527
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. CYRUS B JAVADI
Credential	:	DDS
Telephone Number	:	281-446-6527

Provider Enumeration Date	:	06/09/2010
Last Update Date	:	06/09/2010

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Directions to “ARCH DENTAL PC ” Practice Location

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