Organization
DNTL TEXAS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACKIE MARTINEZ (BOSS LADY)
(281) 703-9468
Entity
Organization
Contact information
Practice address
501 S FRIENDSWOOD DR, FRIENDSWOOD, TX 77546-4508
(281) 554-9090
Mailing address
2750 W MAIN ST STE D, LEAGUE CITY, TX 77573-1830
(281) 554-9090
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
11/24/2021
Last updated
11/24/2021
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