MEDICARE: TILGER CENTER FOR DENTISTRY, PA

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	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1922636380
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TILGER CENTER FOR DENTISTRY, PA

Provider Business Mailing Address
First Line	:	938 GEMINI ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77058-2704
Country	:	US
Telephone Number	:	281-480-6600
Fax Number	:

Provider Business Practice Location Address
First Line	:	938 GEMINI ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77058-2704
Country	:	US
Telephone Number	:	281-480-6600
Fax Number	:	832-827-3828

Authorized Official
Title or Position	:	DENTIST/ OWNER
Name	:	DR. LARRY TILGER
Credential	:	DDS
Telephone Number	:	281-480-6600

Provider Enumeration Date	:	03/31/2020
Last Update Date	:	03/31/2020

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