Organization
TLN FAMILY & COSMETIC DENTAL @ PEARLAND PARKWAY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TAMMEKA NICKLEBERRY DDS (CEO)
(713) 723-2600
Entity
Organization
Contact information
Practice address
2701 PEARLAND PARKWAY, SUITE 201, PEARLAND, TX 77581
(713) 723-2600
Mailing address
63 GENOVA WAY LANE, MISSOURI CITY, TX 77459
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
22283
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
176205602
—
TX
Enumeration date
10/12/2015
Last updated
10/12/2015
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