Organization
TX SOUTHERN DENTAL PPO PC
Active
Other names
Houston Dental Partners
Organization subpart
No
Provider details
NPI number
Authorized official
ERIKA MELISSA MENJIVAR (SR. CREDENTIALING SPECIALIST)
(469) 596-6137
Entity
Organization
Contact information
Practice address
5311 KIRBY DR STE 207, HOUSTON, TX 77005-1339
(713) 528-0377
Mailing address
5830 GRANITE PKWY STE 780, PLANO, TX 75024-6775
(469) 596-6137
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
—
—
Other
Enumeration date
07/11/2024
Last updated
07/11/2024
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