Provider Demographics
NPI:1194852434
Name:CENTER FOR FACIAL PAIN & DENTAL SLEEP MEDICINE
Entity Type:Organization
Organization Name:CENTER FOR FACIAL PAIN & DENTAL SLEEP MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:PREHN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-296-6797
Mailing Address - Street 1:1001 MEDICAL PLAZA DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3241
Mailing Address - Country:US
Mailing Address - Phone:281-296-6797
Mailing Address - Fax:281-296-6887
Practice Address - Street 1:1001 MEDICAL PLAZA DR
Practice Address - Street 2:SUITE 200
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-3241
Practice Address - Country:US
Practice Address - Phone:281-296-6797
Practice Address - Fax:281-296-6887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX193091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty