Provider Demographics
NPI:1326663485
Name:LIMRA DENTAL PLLC
Entity Type:Organization
Organization Name:LIMRA DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AMENA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAMKENATH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:205-563-4843
Mailing Address - Street 1:14829 BELLAIRE BLVD STE 1B
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-2500
Mailing Address - Country:US
Mailing Address - Phone:281-495-7018
Mailing Address - Fax:
Practice Address - Street 1:14829 BELLAIRE BLVD STE 1B
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77083-2500
Practice Address - Country:US
Practice Address - Phone:205-563-4843
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-14
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental