# DENTAL COSMETIC CENTER OF HOUSTON

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- **Entity:** Organization
- **Status:** Active
- **Other names:** None
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588909956
- **Authorized official:** DR. RONALD JENARD MOON DDS (PRESIDENT/DENTIST)
- **Authorized official phone:** (712) 777-6453

## Contact information

- **Practice address:** 4126 SOUTHWEST FWY, SUITE 1610, HOUSTON, TX 77027-7310
- **Practice address phone:** (713) 777-6453
- **Practice address fax:** (713) 850-7847
- **Mailing address:** 4126 SOUTHWEST FWY, SUITE 1610, HOUSTON, TX 77027-7310
- **Mailing address phone:** (713) 777-6453
- **Mailing address fax:** (713) 850-7847

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 19552 | TX | Yes |

## Other

- **Enumeration date:** 12/11/2012
- **Last updated:** 12/11/2012