Provider Demographics
NPI:1760861900
Name:UNIVERSE DENTAL PA
Entity Type:Organization
Organization Name:UNIVERSE DENTAL PA
Other - Org Name:UNIVERSE DENTAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DDS
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:XUE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:713-773-9971
Mailing Address - Street 1:9888 BELLAIRE BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-3431
Mailing Address - Country:US
Mailing Address - Phone:713-773-9971
Mailing Address - Fax:713-773-0336
Practice Address - Street 1:9888 BELLAIRE BLVD STE 120
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-3431
Practice Address - Country:US
Practice Address - Phone:713-773-9971
Practice Address - Fax:713-773-0336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-20
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20668122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty