# CORNERSTONE KIDS DENTAL

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

## Provider details

- **NPI number:** 1790053247
- **Authorized official:** DR. LISA M TREVINO DDS (PEDIATRIC DENTIST)
- **Authorized official phone:** (281) 444-3999

## Contact information

- **Practice address:** 14721 PEBBLE BEND DR, SUITE B, HOUSTON, TX 77068-2929
- **Practice address phone:** (281) 444-3999
- **Practice address fax:** (281) 444-8079
- **Mailing address:** 14721 PEBBLE BEND DR, SUITE B, HOUSTON, TX 77068-2929
- **Mailing address phone:** (281) 444-3999
- **Mailing address fax:** (281) 444-8079

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 24983 | TX | Yes |

## Other

- **Enumeration date:** 12/12/2011
- **Last updated:** 12/12/2011