Organization
WIRT MTD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN PENCHAS DMD (OWNER)
(713) 322-1111
Entity
Organization
Contact information
Practice address
1014 WIRT RD, STE 240, HOUSTON, TX 77055-6883
(713) 322-6666
Mailing address
1014 WIRT RD, STE 240, HOUSTON, TX 77055-6883
(713) 322-6666
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
18415
TX
Other
Enumeration date
02/27/2017
Last updated
02/27/2017
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