Fouat Bend Dental Associates, PLLC
Dentist, General Practice in Missouri City, TX. Organization (NPI-2).
NPI number1467432575
StatusActive
Last updated in NPPESJul 10, 2023
Details
- NPI
- 1467432575
- Entity type
- Organization (NPI-2)
- Legal business name
- Fouat Bend Dental Associates, PLLC
- Organization subpart
- No
- Enumeration date
- Jan 17, 2006
- Certification date
- Jul 10, 2023
- Last updated
- Jul 10, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
| 1223P0300X | Dentist, Periodontics | – | – | |
| 1223E0200X | Dentist, Endodontics | – | – | |
| 1223S0112X | Dentist, Oral and Maxillofacial Surgery | – | – |
Other names
- Fort Bend Dental Associates, PA (Former Legal Business Name)
Practice location
3717 Township LaneMissouri City, TX 77459
Phone 281-499-3541 · Fax 281-605-5956
Mailing address
3717 Township LaneMissouri City, TX 77459
Phone 281-499-3541 · Fax 281-499-3533
Authorized official
Dwight D Peccora
Doctor/Managing Partner
2814993541
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