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Organization
TYME SQUARE DENTAL
Active
Organization
TYME SQUARE DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OLGA MIRIAM IGLESIAS DDS (PRESIDENT)
(718) 614-0328
Entity
Organization
Contact information
Practice address
3440 RILEY FUZZELL RD. SUITE 200, SPRING, TX 77386
(718) 614-0328
Mailing address
30802 LEGENDS TRACE DR, SPRING, TX 77386-3884
(718) 614-0328
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
25301
TX
Other
Enumeration date
03/28/2012
Last updated
03/28/2012
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