Organization
ABC123 PEDIATRIC DENTISTRY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IVETTE DIAZ DDS (PEDIATRIC DENTIST)
(713) 436-8988
Entity
Organization
Contact information
Practice address
1901 KIRBY ST STE 103, PEARLAND, TX 77584-5705
(713) 436-8988
Mailing address
1901 KIRBY ST STE 103, PEARLAND, TX 77584-5705
(713) 436-8988
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
20798
TX
Other
Enumeration date
02/12/2009
Last updated
02/12/2009
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