MEDICARE: AMBER LOVATOS RDH

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	124Q00000X	Dental Hygienist	18428	TX

General Provider Information

NPI Number	:	1881120236
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER LOVATOS RDH

Provider Business Mailing Address
First Line	:	1034 CHERRY SPRING DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77038-2204
Country	:	US
Telephone Number	:	281-253-0966
Fax Number	:

Provider Business Practice Location Address
First Line	:	1034 CHERRY SPRING DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77038-2204
Country	:	US
Telephone Number	:	281-253-0966
Fax Number	:

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

Provider Enumeration Date	:	05/04/2017
Last Update Date	:	05/04/2017

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