Provider Demographics
NPI:1659124121
Name:MICHAEL BOKTOUR DDS PLLC
Entity Type:Organization
Organization Name:MICHAEL BOKTOUR DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BOKTOUR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:832-398-8449
Mailing Address - Street 1:1809 UTAH ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-2103
Mailing Address - Country:US
Mailing Address - Phone:832-398-8449
Mailing Address - Fax:
Practice Address - Street 1:1515 STUDEMONT ST STE 201
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-3823
Practice Address - Country:US
Practice Address - Phone:832-398-8449
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental