Organization
COMMUNITY DENTAL CARE, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRMA FUENTES (OFFICE MANAGER)
(713) 777-8999
Entity
Organization
Contact information
Practice address
8535 W BELLFORT ST, HOUSTON, TX 77071-2207
(713) 777-8999
(713) 988-2422
Mailing address
8535 W BELLFORT ST, HOUSTON, TX 77071-2207
(713) 777-8999
(713) 988-2422
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
17955
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000562408
UNITED CONCORDIA
TX
05
—
091323802
—
TX
01
—
G60068-01
TEXAS CHIP
TX
Enumeration date
05/01/2008
Last updated
05/01/2008
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