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Organization
GALVESTON DENTAL PC
Active
Organization
GALVESTON DENTAL PC
Active
Other names
AFFORDABLE DENTAL GALVESTON
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH OSAMOR DDS (PRESIDENT)
(409) 740-0171
Entity
Organization
Contact information
Practice address
5934 BROADWAY ST, GALVESTON, TX 77551-4305
(409) 740-7744
(409) 744-4541
Mailing address
5934 BROADWAY ST, GALVESTON, TX 77551-4305
(409) 740-7744
(409) 744-4541
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
21886
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
210631201
—
TX
Enumeration date
03/30/2010
Last updated
09/30/2015
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