MEDICARE: MOBERI DENTAL PARTNERS- HILLCROFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	122300000X	Dentist
2	1223E0200X	Endodontics
3	1223G0001X	General Practice Dentistry
4	1223P0221X	Pediatric Dentistry
5	1223P0300X	Periodontics
6	1223P0700X	Prosthodontics
7	1223S0112X	Oral and Maxillofacial Surgery (Dentist)
8	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry

General Provider Information

NPI Number	:	1750849212
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOBERI DENTAL PARTNERS- HILLCROFT

Provider Business Mailing Address
First Line	:	3222 HILLCROFT ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77057-5806
Country	:	US
Telephone Number	:	281-999-9999
Fax Number	:

Provider Business Practice Location Address
First Line	:	3222 HILLCROFT ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77057-5806
Country	:	US
Telephone Number	:	281-999-9999
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JAMES CARNELL MORRISON JR.
Credential	:
Telephone Number	:	281-999-9999

Provider Enumeration Date	:	03/04/2019
Last Update Date	:	03/04/2019

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