# TELEDENTIST365 FOUNDATION

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

## Provider details

- **NPI number:** 1477171973
- **Authorized official:** DR. CHIOMA IMO DDS (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (301) 758-6885

## Contact information

- **Practice address:** 2111 LIMRICK DRIVE, PEARLAND, TX 77581
- **Practice address phone:** (301) 758-6885
- **Mailing address:** 133 N FRIENDSWOOD DR STE 187, FRIENDSWOOD, TX 77546-3746
- **Mailing address phone:** (301) 758-6885

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251K00000X | Public Health or Welfare Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 07/10/2020
- **Last updated:** 07/10/2020