# DENTAL & SPECIALTY IMAGING

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053595868
- **Authorized official:** MR. SHANE FREEMAN (OWNER)
- **Authorized official phone:** (409) 347-8165

## Contact information

- **Practice address:** 3199 DOWLEN RD, SUITE D, BEAUMONT, TX 77706-7284
- **Practice address phone:** (409) 347-8165
- **Practice address fax:** (409) 347-8162
- **Mailing address:** 3199 DOWLEN RD, SUITE D, BEAUMONT, TX 77706-7284
- **Mailing address phone:** (409) 347-8165
- **Mailing address fax:** (409) 347-8162

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0200X | Radiology Clinic/Center | — | TX | Yes |

## Other

- **Enumeration date:** 12/28/2007
- **Last updated:** 07/21/2022