Provider Demographics
NPI:1649601600
Name:ESTEEM DENTAL RIVERGATE
Entity Type:Organization
Organization Name:ESTEEM DENTAL RIVERGATE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:832-349-6286
Mailing Address - Street 1:PO BOX 84703
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-0010
Mailing Address - Country:US
Mailing Address - Phone:281-232-0094
Mailing Address - Fax:
Practice Address - Street 1:1135 CRABB RIVER RD
Practice Address - Street 2:STE 170
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-5896
Practice Address - Country:US
Practice Address - Phone:281-232-0094
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-02
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX258441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty