Organization
BLVD DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY PU (VP OF FINANCE)
(972) 869-3789
Entity
Organization
Contact information
Practice address
1343 W 43RD ST STE F, HOUSTON, TX 77018-4201
(713) 812-8080
(713) 812-8181
Mailing address
2403 LACY LN, CARROLLTON, TX 75006-6514
(972) 869-3789
(972) 869-3791
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
07/25/2014
Last updated
07/25/2014
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