# HULLETT DENTAL GROUP, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Southwest Oral and Implant Surgery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073983755
- **Authorized official:** DR. JASON HULLETT DMD (OWNER/ORAL SURGEON)
- **Authorized official phone:** (201) 407-5181

## Contact information

- **Practice address:** 24 GREENWAY PLZ STE 1708, HOUSTON, TX 77046-2417
- **Practice address phone:** (713) 439-7575
- **Mailing address:** 24 GREENWAY PLZ STE 1708, HOUSTON, TX 77046-2417

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 31059 | TX | Yes |

## Other

- **Enumeration date:** 10/07/2015
- **Last updated:** 10/07/2015