Provider Demographics
NPI:1225538788
Name:JAMBOREE DENTISTRY III PLLC
Entity Type:Organization
Organization Name:JAMBOREE DENTISTRY III PLLC
Other - Org Name:JAMBOREE DENTISTRY III PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:T
Authorized Official - Last Name:SPIGER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:713-644-3000
Mailing Address - Street 1:6336 TELEPHONE RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77087-5410
Mailing Address - Country:US
Mailing Address - Phone:713-644-3000
Mailing Address - Fax:
Practice Address - Street 1:12924 WILLOW CHASE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-5641
Practice Address - Country:US
Practice Address - Phone:713-644-3000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-20
Last Update Date:2018-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24116261QD0000X
TX32476261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental