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Organization
BETHANIEL S JEFFERSON, DDS, PC
Active
Organization
BETHANIEL S JEFFERSON, DDS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BETHANIEL JEFFERSON (OWNER)
(281) 895-7787
Entity
Organization
Contact information
Practice address
15531 KUYKENDAHL RD, STE 180, HOUSTON, TX 77090-3645
(281) 895-7787
Mailing address
15531 KUYKENDAHL RD, STE 180, HOUSTON, TX 77090
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
Other
Enumeration date
02/07/2008
Last updated
02/07/2008
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