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Organization
MAGICO DENTAL PLLC
Active
Organization
MAGICO DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS NELI GUEVARA (BILLING DIRECTOR)
(281) 974-3996
Entity
Organization
Contact information
Practice address
5803 LYONS AVE, HOUSTON, TX 77020-4833
(281) 974-3996
Mailing address
900 S WAYSIDE DR STE 100, HOUSTON, TX 77023-3418
(832) 203-7968
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34745052
DRIVERS LICENSE
TX
Enumeration date
06/12/2018
Last updated
06/16/2018
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