Organization
CEDAR PARK PERIODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRATHIMA VEMULAPALLI DMD, MMSC (OWNER)
(617) 283-6428
Entity
Organization
Contact information
Practice address
1803 BRIARPARK DR, HOUSTON, TX 77042-2101
(617) 283-6428
Mailing address
1803 BRIARPARK DR, HOUSTON, TX 77042-2101
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
25248
TX
Other
Enumeration date
01/28/2015
Last updated
01/28/2015
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