Provider Demographics
NPI:1376656249
Name:DOWNTOWN DENTAL ASSOCIATES
Entity Type:Organization
Organization Name:DOWNTOWN DENTAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MIRIAM
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:FOLTA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:713-227-5757
Mailing Address - Street 1:808 TRAVIS ST STE T60
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-5760
Mailing Address - Country:US
Mailing Address - Phone:713-227-5757
Mailing Address - Fax:713-225-1844
Practice Address - Street 1:808 TRAVIS ST STE T60
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-5760
Practice Address - Country:US
Practice Address - Phone:713-227-5757
Practice Address - Fax:713-225-1844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX119701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty