Organization
DENTAL VIP, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAURENCE E FENDRICH DMD (MEMBER)
(561) 715-1010
Entity
Organization
Contact information
Practice address
404 W POWELL LN STE 102, AUSTIN, TX 78753-6256
(561) 715-1010
Mailing address
3262 WESTHEIMER RD # 833, HOUSTON, TX 77098-1002
(561) 715-1010
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34315
TX DENTAL LICENSE
TX
Enumeration date
07/13/2018
Last updated
10/15/2024
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