Provider Demographics
NPI:1598887838
Name:GHATTAS, PIERRE MINA (DDS)
Entity Type:Individual
Prefix:DR
First Name:PIERRE
Middle Name:MINA
Last Name:GHATTAS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 GREEN OAK PL STE B
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-2489
Mailing Address - Country:US
Mailing Address - Phone:281-358-2191
Mailing Address - Fax:
Practice Address - Street 1:1520 GREEN OAK PL
Practice Address - Street 2:STE B
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-2489
Practice Address - Country:US
Practice Address - Phone:281-358-2191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX226211223G0001X
CT0098791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice