Organization
DIAZ AND GILES PA
Active
Other names
Marketplace Dental Group and Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARIA DIAZ (REGISTERED AGENT)
(936) 441-4455
Entity
Organization
Contact information
Practice address
402 SIMONTON ST, SUITE # 100, CONROE, TX 77301-2666
(936) 441-4455
Mailing address
402 SIMONTON STREET, SUITE # 100, CONROE, TX 77301
(936) 441-4455
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
TX
Other
Enumeration date
03/08/2010
Last updated
03/08/2010
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