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Organization

FAV-ULOS DENTAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
FABIOLA GARCIA DE ROCHA DR (OWNER)
(713) 468-1400
Entity
Organization

Contact information

Practice address
8762 LONG POINT RD STE 102, HOUSTON, TX 77055-3016
(713) 468-1400
Mailing address
8762 LONG POINT RD STE 102, HOUSTON, TX 77055-3016
(713) 468-1400

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
30122
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3372039
TX
Enumeration date
08/17/2018
Last updated
08/17/2018
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