Individual
IAN ANTHONY SPORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6421 W 43RD ST, HOUSTON, TX 77092-4005
(817) 217-5110
Mailing address
155 BIRDSALL ST, #406, HOUSTON, TX 77007-2569
(817) 217-5110
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
31190
TX
Other
Enumeration date
07/13/2015
Last updated
07/13/2015
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