Provider Demographics
NPI:1215043518
Name:GENNERO, DEBORAH (DDS)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:
Last Name:GENNERO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16225 PARK TEN PL STE 695
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-5189
Mailing Address - Country:US
Mailing Address - Phone:281-578-6200
Mailing Address - Fax:281-578-8858
Practice Address - Street 1:16225 PARK TEN PL STE 695
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-5189
Practice Address - Country:US
Practice Address - Phone:281-578-6200
Practice Address - Fax:281-578-8858
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX147571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice