Provider Demographics
NPI:1699208132
Name:SOYE DENTAL SPA PLLC
Entity Type:Organization
Organization Name:SOYE DENTAL SPA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MULIKAT
Authorized Official - Middle Name:ADEBIMPE
Authorized Official - Last Name:ADETOSOYE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:281-206-7289
Mailing Address - Street 1:20710 WESTHEIMER PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-6256
Mailing Address - Country:US
Mailing Address - Phone:281-206-7289
Mailing Address - Fax:832-321-3957
Practice Address - Street 1:20710 WESTHEIMER PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-6256
Practice Address - Country:US
Practice Address - Phone:281-206-7289
Practice Address - Fax:832-321-3957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-11
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX310891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty