Organization
DUTTON LEWIS FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MELONIE RACHEL DUTTON D.D.S. (PEDIATRICS) (OWNER)
(713) 633-5717
Entity
Organization
Contact information
Practice address
4418 ALMEDA RD, HOUSTON, TX 77004-4902
(713) 633-5717
Mailing address
4418 ALMEDA RD, HOUSTON, TX 77004-4902
(713) 633-5717
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
17982
TX
1223P0221X
Pediatric Dentistry
Primary
17982
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01367667
UNITED CONCORDIA
TX
05
—
149758801
—
TX
01
—
G60405-02
CHIPS
TX
Enumeration date
02/20/2008
Last updated
03/15/2010
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