Provider Demographics
NPI:1093213829
Name:BRISK DENTAL
Entity Type:Organization
Organization Name:BRISK DENTAL
Other - Org Name:DENTAL ART
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SEHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MARIAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-689-0444
Mailing Address - Street 1:5901 WESTHEIMER RD STE D
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-7607
Mailing Address - Country:US
Mailing Address - Phone:713-228-3384
Mailing Address - Fax:832-991-8108
Practice Address - Street 1:5901 WESTHEIMER RD STE D
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-7607
Practice Address - Country:US
Practice Address - Phone:713-228-3384
Practice Address - Fax:832-991-8108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-26
Last Update Date:2018-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty