Bellaire Dental Suite PLLC
Dentist in Bellaire, TX. Organization (NPI-2).
NPI number1992586234
StatusActive
Last updated in NPPESOct 12, 2023
Details
- NPI
- 1992586234
- Entity type
- Organization (NPI-2)
- Legal business name
- Bellaire Dental Suite PLLC
- Organization subpart
- No
- Enumeration date
- Oct 12, 2023
- Certification date
- Oct 12, 2023
- Last updated
- Oct 12, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | – | – | Yes |
| 1223P0700X | Dentist, Prosthodontics | – | – |
Other names
- Bellaire Dental Suite (Doing Business As)
Practice location
6300 West Loop S Ste 250Bellaire, TX 77401-2918
Phone 346-618-5441 · Fax 346-204-4160
Mailing address
110 E Villa Maria Rd Ste ABryan, TX 77801-3147
Phone 979-779-6146 · Fax 979-779-6250
Authorized official
Kristina Rivers
Owner
8179250458
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