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NPI Code Detail

MEDICARE: FULTON DENTAL ASSOCIATES, PA

MEDICARE: FULTON 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 Dentistry

General Provider Information

NPI Number : 1649264102
Entity Type Code : Organization
Provider Name (Legal Business Name) : FULTON DENTAL ASSOCIATES, PA
Provider Business Mailing Address
First Line : 2445 FULTON ST
Second Line : SUITE #B
City : HOUSTON
State : TX
Zip : 77009-7837
Country : US
Telephone Number : 713-225-2266
Fax Number : 713-225-2275
Provider Business Practice Location Address
First Line : 2445 FULTON ST
Second Line : SUITE #B
City : HOUSTON
State : TX
Zip : 77009-7837
Country : US
Telephone Number : 713-225-2266
Fax Number : 713-225-2275
Authorized Official
Title or Position : OWNER
Name : SHANNON DENISE PRESLEY
Credential : D.D.S.
Telephone Number : 713-225-2266
Provider Enumeration Date : 09/09/2005
Last Update Date : 08/22/2020

Similar Medicare Providers

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Directions to “FULTON DENTAL ASSOCIATES, PA ” Practice Location

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