Organization
DENTAL AESTHETICS OF TEXAS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEREK TILLMAN D.M.D. (MANAGER)
(713) 444-7768
Entity
Organization
Contact information
Practice address
6120 SCOTT ST STE B, HOUSTON, TX 77021-2698
(713) 444-7768
Mailing address
PO BOX 300448, HOUSTON, TX 77230-0448
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
04/24/2012
Last updated
12/01/2012
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