Organization
BAYBROOK MALL DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROSTISLAV KRASNOV DDS (OWNER)
(917) 902-9515
Entity
Organization
Contact information
Practice address
1012 BAYBROOK MALL, FRIENDSWOOD, TX 77546-2744
(281) 461-6515
Mailing address
1012 BAYBROOK MALL, FRIENDSWOOD, TX 77546-2744
(281) 461-6515
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN16377
FL
Other
Enumeration date
02/21/2013
Last updated
12/04/2014
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