Provider Demographics
NPI:1467748327
Name:MISSONNI DENTAL PLLC
Entity Type:Organization
Organization Name:MISSONNI DENTAL PLLC
Other - Org Name:HOBBY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEMSEGED
Authorized Official - Middle Name:DEGEFU
Authorized Official - Last Name:MISSONNE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:832-767-4782
Mailing Address - Street 1:8426 WINKLER DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77017-5062
Mailing Address - Country:US
Mailing Address - Phone:832-767-4782
Mailing Address - Fax:
Practice Address - Street 1:8426 WINKLER DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77017-5062
Practice Address - Country:US
Practice Address - Phone:832-767-4782
Practice Address - Fax:877-425-4661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-20
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX247631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty