Organization
IESOUS DENTAL PLLC
Active
Other names
hyatt dental bellaire
Organization subpart
No
Provider details
NPI number
Authorized official
VERONICA GRACIA (OFFICE MANAGER)
(346) 354-3505
Entity
Organization
Contact information
Practice address
13442 BELLAIRE BLVD STE D, HOUSTON, TX 77083-2641
(832) 232-5353
Mailing address
13442 BELLAIRE BLVD STE D, HOUSTON, TX 77083-2641
(832) 232-5353
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
307467606
—
TX
Enumeration date
09/23/2022
Last updated
11/08/2022
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