Provider Demographics
NPI:1518560291
Name:POLISH DENTISTRY, P.A.
Entity Type:Organization
Organization Name:POLISH DENTISTRY, P.A.
Other - Org Name:POLISH DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRIANNE
Authorized Official - Middle Name:E
Authorized Official - Last Name:TALAMANTEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-523-9655
Mailing Address - Street 1:PO BOX 270155
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77277-0155
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:215 WESTHEIMER RD STE 200
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-3221
Practice Address - Country:US
Practice Address - Phone:713-942-0101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-17
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty