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Organization
LIFETIME DENTAL, PA
Active
Organization
LIFETIME DENTAL, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SAMANEH MARYAM DAFTARIAN D.D.S (DENTIST/ PRESIDENT)
(281) 213-8666
Entity
Organization
Contact information
Practice address
10750 BARKER CYPRESS RD STE 111, CYPRESS, TX 77433-2282
(281) 213-8666
(281) 256-2819
Mailing address
10750 BARKER CYPRESS RD STE 111, CYPRESS, TX 77433-2282
(281) 213-8666
(281) 256-2819
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
178127001
—
TX
Enumeration date
03/12/2008
Last updated
11/08/2011
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