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Organization
SPECTRUM DENTAL GROUP
Active
Organization
SPECTRUM DENTAL GROUP
Active
Other names
VanEenenaam, William
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM VANEENENAAM D.D.S (PRESIDENT)
(713) 228-3384
Entity
Organization
Contact information
Practice address
5901 WESTHEIMER RD STE D, HOUSTON, TX 77057-7607
(713) 228-3384
(713) 953-7115
Mailing address
5901 WESTHEIMER RD STE D, HOUSTON, TX 77057-7607
(713) 228-3384
(713) 953-7115
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12767
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1992916217
—
TX
05
—
MEDICAID
—
TX
Enumeration date
08/08/2006
Last updated
07/30/2012
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