Provider Demographics
NPI:1609171925
Name:A DENTAL GROUP
Entity Type:Organization
Organization Name:A DENTAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAHRZAD
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMEA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:713-466-6666
Mailing Address - Street 1:8511 N HOUSTON ROSSLYN RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77088-6431
Mailing Address - Country:US
Mailing Address - Phone:713-466-6666
Mailing Address - Fax:
Practice Address - Street 1:8511 N HOUSTON ROSSLYN RD
Practice Address - Street 2:SUITE 210
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77088-6431
Practice Address - Country:US
Practice Address - Phone:713-466-6666
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-18
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX188831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty