# MISSION BEND FAMILY DENTISTRY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366002883
- **Authorized official:** JENNIFER MILLER (OFFICE MANAGER)
- **Authorized official phone:** (832) 500-4940

## Contact information

- **Practice address:** 7039 FM 1464 RD STE 130, RICHMOND, TX 77407-2001
- **Practice address phone:** (832) 500-4940
- **Practice address fax:** (832) 532-7392
- **Mailing address:** 7039 FM 1464 RD STE 130, RICHMOND, TX 77407-2001
- **Mailing address phone:** (832) 500-4940
- **Mailing address fax:** (832) 532-7392

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/17/2019
- **Last updated:** 06/17/2019