# BELLAIRE DENTAL SUITE PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Bellaire Dental Suite
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992586234
- **Authorized official:** KRISTINA RIVERS DDS (OWNER)
- **Authorized official phone:** (817) 925-0458

## Contact information

- **Practice address:** 6300 WEST LOOP S STE 250, BELLAIRE, TX 77401-2918
- **Practice address phone:** (346) 618-5441
- **Practice address fax:** (346) 204-4160
- **Mailing address:** 110 E VILLA MARIA RD STE A, BRYAN, TX 77801-3147
- **Mailing address phone:** (979) 779-6146
- **Mailing address fax:** (979) 779-6250

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | Yes |
| 1223P0700X | Prosthodontics | — | — | — |

## Other

- **Enumeration date:** 10/12/2023
- **Last updated:** 10/12/2023