Provider Demographics
NPI:1598088403
Name:DENTART PC
Entity Type:Organization
Organization Name:DENTART PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:GLEN
Authorized Official - Last Name:ROJAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:713-426-4880
Mailing Address - Street 1:6311 WASHINGTON AVE
Mailing Address - Street 2:SUTIE A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-2108
Mailing Address - Country:US
Mailing Address - Phone:713-426-4880
Mailing Address - Fax:713-426-4862
Practice Address - Street 1:2925 W TC JESTER BLVD
Practice Address - Street 2:SUITE 4
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77018-7061
Practice Address - Country:US
Practice Address - Phone:713-686-2930
Practice Address - Fax:713-686-2921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-05
Last Update Date:2010-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1223G0001X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty