Provider Demographics
NPI:1629292610
Name:ADULT & CHILDREN DENTAL PARTNERS PA
Entity Type:Organization
Organization Name:ADULT & CHILDREN DENTAL PARTNERS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:PINER
Authorized Official - Last Name:GRILLI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-488-2483
Mailing Address - Street 1:17100 GLENMOUNT PARK DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4368
Mailing Address - Country:US
Mailing Address - Phone:281-488-2483
Mailing Address - Fax:281-488-3416
Practice Address - Street 1:17100 GLENMOUNT PARK DR
Practice Address - Street 2:SUITE A
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4368
Practice Address - Country:US
Practice Address - Phone:281-488-2483
Practice Address - Fax:281-488-3416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX169051223G0001X
TX159861223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Not Answered1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty