Provider Demographics
NPI:1598038051
Name:RENGER, EVERETT JR (DDS,MS)
Entity Type:Individual
Prefix:DR
First Name:EVERETT
Middle Name:
Last Name:RENGER
Suffix:JR
Gender:M
Credentials:DDS,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9099 KATY FWY
Mailing Address - Street 2:SUITE 175
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-1640
Mailing Address - Country:US
Mailing Address - Phone:713-461-5910
Mailing Address - Fax:713-468-8528
Practice Address - Street 1:9099 KATY FWY
Practice Address - Street 2:SUITE 175
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-1640
Practice Address - Country:US
Practice Address - Phone:713-461-5910
Practice Address - Fax:713-468-8528
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-14
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7419822811223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics