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NPI Code Detail

MEDICARE: WINIFRED O DIKE DDS

MEDICARE:   WINIFRED O DIKE  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
11223G0001XGeneral Practice Dentistry21637TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1912050550
Entity Type Code : Individual
Provider Name (Legal Business Name) : WINIFRED O DIKE DDS
Provider Business Mailing Address
First Line : 8614 S BRAESWOOD BLVD
Second Line :
City : HOUSTON
State : TX
Zip : 77031-1301
Country : US
Telephone Number : 713-777-3368
Fax Number : 713-777-3370
Provider Business Practice Location Address
First Line : 8614 S BRAESWOOD BLVD
Second Line :
City : HOUSTON
State : TX
Zip : 77031-1301
Country : US
Telephone Number : 713-777-3368
Fax Number : 713-777-3370
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2007
Last Update Date : 07/08/2007

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Directions to “ WINIFRED O DIKE DDS” Practice Location

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