Provider Demographics
NPI:1376236745
Name:TULIP DENTAL CARE PLLC
Entity Type:Organization
Organization Name:TULIP DENTAL CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:QAYS BAQER
Authorized Official - Last Name:WITWIT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-787-3161
Mailing Address - Street 1:3 GROGANS PARK DR STE 100
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77380-2922
Mailing Address - Country:US
Mailing Address - Phone:281-364-9880
Mailing Address - Fax:
Practice Address - Street 1:3 GROGANS PARK DR STE 100
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77380-2922
Practice Address - Country:US
Practice Address - Phone:281-364-9880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-31
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty