Organization
CITYDDS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH B ILUSTRE DDS (PRESIDENT)
(832) 863-2702
Entity
Organization
Contact information
Practice address
17100 GLENMOUNT PARK DR, WEBSTER, TX 77598-4368
(281) 488-2483
Mailing address
17100 GLENMOUNT PARK DR, WEBSTER, TX 77598-4368
(281) 488-2483
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223D0004X
Dental Anesthesiology
—
—
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
12/21/2023
Last updated
12/21/2023
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