Provider Demographics
NPI:1568249910
Name:MAK DDS PLLC
Entity Type:Organization
Organization Name:MAK DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CASANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAMORA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-280-4410
Mailing Address - Street 1:1013 DAIRY ASHFORD RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-4602
Mailing Address - Country:US
Mailing Address - Phone:832-280-4410
Mailing Address - Fax:281-903-7471
Practice Address - Street 1:1013 DAIRY ASHFORD RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-4602
Practice Address - Country:US
Practice Address - Phone:832-280-4410
Practice Address - Fax:281-903-7471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXFK7103132OtherSTATE OF TEXAS