Organization
FORTUNE PHI, PA
Active
Other names
Dentiq Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SRIDHAR SISTA (OWNER)
(713) 526-2904
Entity
Organization
Contact information
Practice address
1355 W GRAY ST, HOUSTON, TX 77019-4019
(713) 526-2904
Mailing address
1355 W GRAY ST, HOUSTON, TX 77019-4019
(713) 526-2904
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/03/2006
Last updated
04/16/2020
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