Provider Demographics
NPI:1760866438
Name:ASSOCIATES FOR DENTAL HEALTH, PLLC
Entity Type:Organization
Organization Name:ASSOCIATES FOR DENTAL HEALTH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDRESS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-738-1579
Mailing Address - Street 1:304 W BAY AREA BLVD
Mailing Address - Street 2:STE 300
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4156
Mailing Address - Country:US
Mailing Address - Phone:281-738-1579
Mailing Address - Fax:713-490-6464
Practice Address - Street 1:304 W BAY AREA BLVD
Practice Address - Street 2:STE 300
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4156
Practice Address - Country:US
Practice Address - Phone:281-738-1579
Practice Address - Fax:713-490-6464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-13
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6626122300000X, 1223X0400X
1223E0200X, 1223G0001X, 1223P0221X, 1223P0300X, 1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty