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Organization
INNOVATIVE DENTISTRY OF FALL CREEK, PLLC
Active
Organization
INNOVATIVE DENTISTRY OF FALL CREEK, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDGAR MAFLA DDS (OWNER)
(346) 616-5350
Entity
Organization
Contact information
Practice address
8303 N SAM HOUSTON PKWY E STE C, HUMBLE, TX 77396-4933
(346) 616-5350
(346) 616-5353
Mailing address
8303 N SAM HOUSTON PKWY E STE C, HUMBLE, TX 77396-4933
(346) 616-5350
(346) 616-5353
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
24793
TX
Other
Enumeration date
09/08/2017
Last updated
07/21/2022
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