Provider Demographics
NPI:1083208284
Name:MI FAMILIA DENTAL PLLC
Entity Type:Organization
Organization Name:MI FAMILIA DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNOZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-495-3213
Mailing Address - Street 1:2421 ALDINE MAIL RTE STE D
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77039-5530
Mailing Address - Country:US
Mailing Address - Phone:281-617-8960
Mailing Address - Fax:281-617-7012
Practice Address - Street 1:2421 ALDINE MAIL RTE STE D
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77039-5530
Practice Address - Country:US
Practice Address - Phone:281-617-8960
Practice Address - Fax:281-617-7012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-28
Last Update Date:2021-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center