Organization
LA MICHOACANA DENTAL CLINIC#3 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ADELINA PABLOS MONTY DDS (OWNER)
(713) 691-1188
Entity
Organization
Contact information
Practice address
6333 BARKER CYPRESS RD, SUITE A, HOUSTON, TX 77084-1625
(713) 691-1188
(713) 691-1196
Mailing address
6333 BARKER CYPRESS RD, SUITE A, HOUSTON, TX 77084-1625
(713) 691-1188
(713) 691-1196
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
18185
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
126781986
—
TX
Enumeration date
09/11/2012
Last updated
09/19/2012
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