MEDICARE: DR. JUDITH MABRITO DDS

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	122300000X	Dentist	14420	TX

General Provider Information

NPI Number	:	1831182211
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUDITH MABRITO DDS

Provider Business Mailing Address
First Line	:	700 LOUISIANA ST
Second Line	:	STE 2430
City	:	HOUSTON
State	:	TX
Zip	:	77002-2700
Country	:	US
Telephone Number	:	713-224-0408
Fax Number	:	713-224-0491

Provider Business Practice Location Address
First Line	:	700 LOUISIANA ST
Second Line	:	STE 2430
City	:	HOUSTON
State	:	TX
Zip	:	77002-2700
Country	:	US
Telephone Number	:	713-224-0408
Fax Number	:	713-224-0491

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2005
Last Update Date	:	07/08/2007

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