Provider Demographics
NPI:1609381532
Name:DENTAL SERVICES MANAGEMENT CORPORATION
Entity Type:Organization
Organization Name:DENTAL SERVICES MANAGEMENT CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:EWING
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:713-467-3458
Mailing Address - Street 1:791 TOWN AND COUNTRY BLVD STE 222
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-3978
Mailing Address - Country:US
Mailing Address - Phone:713-467-3458
Mailing Address - Fax:
Practice Address - Street 1:791 TOWN AND COUNTRY BLVD STE 222
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-3978
Practice Address - Country:US
Practice Address - Phone:713-467-3458
Practice Address - Fax:713-467-7902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-14
Last Update Date:2017-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty