Organization
LA MICHOACANA DENTAL CLINIC #2
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ADELINA P MONTY DDS (OWNER)
(281) 416-4385
Entity
Organization
Contact information
Practice address
6500 SPENCER HWY, SUITE 120, PASADENA, TX 77505-1704
(281) 416-4385
(281) 741-9546
Mailing address
6500 SPENCER HWY, SUITE 120, PASADENA, TX 77505-1704
(281) 416-4385
(281) 741-9546
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
18185
TX
261QD0000X
Dental Clinic/Center
27247
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
126781986
—
TX
05
—
270255489
—
TX
Enumeration date
06/14/2012
Last updated
06/14/2012
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