MEDICARE: GMORGAN DENTAL PLLC

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	18850	TX

General Provider Information

NPI Number	:	1689975971
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GMORGAN DENTAL PLLC

Provider Business Mailing Address
First Line	:	8514 BELLAIRE BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77036-4704
Country	:	US
Telephone Number	:	713-779-6900
Fax Number	:	713-779-6900

Provider Business Practice Location Address
First Line	:	8514 BELLAIRE BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77036-4704
Country	:	US
Telephone Number	:	713-779-6900
Fax Number	:	713-779-6900

Authorized Official
Title or Position	:	GENERAL MANAGER
Name	:	MS. IRMA FUENTES
Credential	:
Telephone Number	:	713-779-6900

Provider Enumeration Date	:	11/03/2010
Last Update Date	:	11/09/2010

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Directions to “GMORGAN DENTAL PLLC ” Practice Location

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