Provider Demographics
NPI:1417114299
Name:ADVANTAGE DENTISTS HUMBLE
Entity Type:Organization
Organization Name:ADVANTAGE DENTISTS HUMBLE
Other - Org Name:ADVANTAGE DENTISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:K
Authorized Official - Last Name:UMANSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-446-4600
Mailing Address - Street 1:6818 ATASCOCITA RD
Mailing Address - Street 2:
Mailing Address - City:ATASCOCITA
Mailing Address - State:TX
Mailing Address - Zip Code:77346-2817
Mailing Address - Country:US
Mailing Address - Phone:281-446-4600
Mailing Address - Fax:
Practice Address - Street 1:5363 ATASCOCITA RD
Practice Address - Street 2:
Practice Address - City:ATASCOCITA
Practice Address - State:TX
Practice Address - Zip Code:77346-2842
Practice Address - Country:US
Practice Address - Phone:281-446-4600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty