Provider Demographics
NPI:1508925769
Name:HEATHER FERAY BOHAN DDS PA
Entity Type:Organization
Organization Name:HEATHER FERAY BOHAN DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER GENERAL DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:DANIELLE
Authorized Official - Last Name:FERAY BOHAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS PA
Authorized Official - Phone:281-357-5002
Mailing Address - Street 1:720 LAWRENCE ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375
Mailing Address - Country:US
Mailing Address - Phone:281-357-5002
Mailing Address - Fax:281-255-3016
Practice Address - Street 1:720 LAWRENCE ST
Practice Address - Street 2:SUITE 200
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375
Practice Address - Country:US
Practice Address - Phone:281-357-5002
Practice Address - Fax:281-255-3016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX205401223G0001X
TX101201124Q00000X
126800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Not Answered124Q00000XDental ProvidersDental HygienistGroup - Multi-Specialty
Not Answered126800000XDental ProvidersDental AssistantGroup - Multi-Specialty