Organization
AIRLINE DENTAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRASEMA CAMPA (ADMINISTRATIVE ASST)
(713) 697-2631
Entity
Organization
Contact information
Practice address
5990 AIRLINE DR, SUITE 180, HOUSTON, TX 77076-4233
(713) 694-8333
Mailing address
5990 AIRLINE DR, SUITE 180, HOUSTON, TX 77076-4233
(713) 694-8333
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
16842
TX
122300000X
Dentist
Primary
22558
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009806301
—
TX
Enumeration date
05/27/2008
Last updated
12/06/2011
Update your record
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