# FM 362 FAMILY DENTAL PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** FM 362 Family Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316663081
- **Authorized official:** MS. MARIA CAMACHO (MANAGER)
- **Authorized official phone:** (346) 633-6825

## Contact information

- **Practice address:** 19530 FM 362 RD, WALLER, TX 77484-5065
- **Practice address phone:** (346) 633-6825
- **Practice address fax:** (346) 857-0166
- **Mailing address:** 19530 FM 362 RD, WALLER, TX 77484-5065

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | — |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 10/14/2022
- **Last updated:** 04/23/2024