# KINGWOOD DENTAL SPECIALISTS PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Greater Houston Dental Specialists
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255616538
- **Authorized official:** BECKY KEEFER (ACCOUNTS RECEIVABLE MGR)
- **Authorized official phone:** (832) 399-7450

## Contact information

- **Practice address:** 1414 GREEN OAK TERRACE CT STE 400, KINGWOOD, TX 77339-2960
- **Practice address phone:** (281) 359-1011
- **Mailing address:** 1414 GREEN OAK TERRACE CT STE 400, KINGWOOD, TX 77339-2960
- **Mailing address phone:** (281) 359-1011

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 22853 | TX | — |
| 1223P0300X | Periodontics | 19503 | TX | — |
| 1223P0300X | Periodontics | 22814 | TX | — |
| 1223P0700X | Prosthodontics | 18851 | TX | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 11684 | TX | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 22605 | TX | — |

## Other

- **Enumeration date:** 10/18/2011
- **Last updated:** 10/18/2011