Provider Demographics
NPI:1689054991
Name:CAMMARATA DENTAL ASSOCIATES-LEAGUE CITY, PLLC
Entity Type:Organization
Organization Name:CAMMARATA DENTAL ASSOCIATES-LEAGUE CITY, PLLC
Other - Org Name:CAMMARATA PEDIATRIC DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RITA
Authorized Official - Middle Name:MAXINE
Authorized Official - Last Name:CAMMARATA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:713-666-7884
Mailing Address - Street 1:3831 EAST LEAGUECITY PARKWAY
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573
Mailing Address - Country:US
Mailing Address - Phone:713-666-7884
Mailing Address - Fax:
Practice Address - Street 1:3831 EAST LEAGUECITY PARKWAY
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573
Practice Address - Country:US
Practice Address - Phone:713-666-7884
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-02
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty