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NPI Code Detail

MEDICARE: TEXAS DENTAL ASSOCIATES, PA

MEDICARE: TEXAS DENTAL ASSOCIATES, PA
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 Dentistry10849TX

General Provider Information

NPI Number : 1417067968
Entity Type Code : Organization
Provider Name (Legal Business Name) : TEXAS DENTAL ASSOCIATES, PA
Provider Business Mailing Address
First Line : 2536 AMHERST ST
Second Line : SUITE A
City : HOUSTON
State : TX
Zip : 77005-3207
Country : US
Telephone Number : 713-490-8880
Fax Number : 713-490-6464
Provider Business Practice Location Address
First Line : 6137 KIRBY DR
Second Line :
City : HOUSTON
State : TX
Zip : 77005-3148
Country : US
Telephone Number : 713-490-8888
Fax Number : 713-490-6462
Authorized Official
Title or Position : OWNER
Name : DR. KENT E. ZIEGENBEIN
Credential : D.D.S.
Telephone Number : 713-490-8880
Provider Enumeration Date : 08/30/2006
Last Update Date : 01/21/2011

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Directions to “TEXAS DENTAL ASSOCIATES, PA ” Practice Location

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