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Organization
IMMANUEL DENTAL CENTER
Active
Organization
IMMANUEL DENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NAGY B GHATTAS D.D.S (DENTISTS)
(281) 286-5867
Entity
Organization
Contact information
Practice address
1147 CLEAR LAKE CITY BLVD, HOUSTON, TX 77062-8102
(281) 286-5867
(281) 286-6551
Mailing address
1147 CLEAR LAKE CITY BLVD, HOUSTON, TX 77062-8102
(281) 286-5867
(281) 286-6551
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
163581501
—
TX
Enumeration date
04/27/2010
Last updated
04/27/2010
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