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NPI Code Detail

MEDICARE: OAK RIDGE NORTH ROBINSON ROAD DENTAL PC

MEDICARE: OAK RIDGE NORTH ROBINSON ROAD DENTAL PC
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
1261QD0000XDental Clinic/Center20388TX

General Provider Information

NPI Number : 1912480740
Entity Type Code : Organization
Provider Name (Legal Business Name) : OAK RIDGE NORTH ROBINSON ROAD DENTAL PC
Provider Business Mailing Address
First Line : 27326 ROBINSON RD STE 108
Second Line :
City : OAK RIDGE NORTH
State : TX
Zip : 77385-8960
Country : US
Telephone Number : 281-586-4600
Fax Number : 281-586-7051
Provider Business Practice Location Address
First Line : 27326 ROBINSON RD STE 108
Second Line :
City : OAK RIDGE NORTH
State : TX
Zip : 77385-8960
Country : US
Telephone Number : 281-586-4600
Fax Number : 281-586-7051
Authorized Official
Title or Position : SR CREDENTIALING SPECIALIST
Name : MAGGI EVANS
Credential :
Telephone Number : 720-603-4800
Provider Enumeration Date : 09/07/2018
Last Update Date : 10/14/2024

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Directions to “OAK RIDGE NORTH ROBINSON ROAD DENTAL PC ” Practice Location

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