Centra One Dental Pa

NPI 1174869580 - Dentist - 1223G0001X

NPI Details
NPI 1174869580
Enumeration Date 12/13/2012
Last Updated 01/16/2013
Entity Type Healthcare Provider
Active Over 3 years ago
Authorized Information
Name KATHY KATHY
Position DENTIST/OWNER
Phone (713) 433-7500
Fax
Practice Location
4318 W FUQUA ST
HOUSTON TX, 77045-6204, US
Phone (713) 433-7500
Fax
Business Location
4318 W FUQUA ST
HOUSTON TX, 77045-6204, US
Phone (713) 433-7500
Fax
Toxanomy
Taxonomy Code 1223G0001X
License State Texas
License Number 25748
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According to our database, Centra One Dental Pa NPI is 1174869580, taxonomy code is 1223G0001X and license number is 25748, license state is located at Texas. Centra One Dental Pa physically located at 4318 W Fuqua St, Houston TX, 77045-6204. NPI Number 1033115704 has the healthcare provider type.

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1174869580 NPI number is provided on an as is basis without warranty of any kind. 1174869580 is maintained by the National Plan & Provider Enumeration System. The contents of Centra One Dental Pa are for informational purposes only.