Provider Demographics
NPI:1760980312
Name:CHAROLIA SK DENTAL PLLC
Entity Type:Organization
Organization Name:CHAROLIA SK DENTAL PLLC
Other - Org Name:PEARL SHINE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SAHEGIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAROLIA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-631-5114
Mailing Address - Street 1:7506 MONTECREST PARK CT
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-1488
Mailing Address - Country:US
Mailing Address - Phone:281-631-5114
Mailing Address - Fax:
Practice Address - Street 1:12220 JONES RD STE C
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-5266
Practice Address - Country:US
Practice Address - Phone:281-631-5114
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-30
Last Update Date:2018-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX28099261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental