Organization
BROOKSHIRE SMILE, PA
Active
Other names
Brookshire Smile Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOHAMMAD MORIDNIA D.D.S (VICE PRESIDENT/ DENTIST)
(281) 934-1010
Entity
Organization
Contact information
Practice address
3603 SOUTH FRONT STREET, SUITE 107, BROOKSHIRE, TX 77423-9457
(281) 934-1010
Mailing address
3603 SOUTH FRONT STREET, SUITE 107, BROOKSHIRE, TX 77423-9457
(281) 934-1010
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
27064
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2828576
—
TX
Enumeration date
08/27/2013
Last updated
08/27/2013
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