Provider Demographics
NPI:1568712909
Name:RICHMOND AVENUE DENTAL CARE
Entity Type:Organization
Organization Name:RICHMOND AVENUE DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FADI
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:SALHA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:713-785-0234
Mailing Address - Street 1:7700 SAN FELIPE ST STE 150
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-1691
Mailing Address - Country:US
Mailing Address - Phone:713-785-0234
Mailing Address - Fax:713-785-3857
Practice Address - Street 1:6060 RICHMOND AVE STE 210
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-6262
Practice Address - Country:US
Practice Address - Phone:713-785-0234
Practice Address - Fax:713-785-3857
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-13
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX160161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty