Provider Demographics
NPI:1790102721
Name:KRB DENTISTRY
Entity Type:Organization
Organization Name:KRB DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAUSER
Authorized Official - Middle Name:
Authorized Official - Last Name:BARI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:713-530-7373
Mailing Address - Street 1:5110 AVENUE H
Mailing Address - Street 2:SUITE MO5
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77471-2014
Mailing Address - Country:US
Mailing Address - Phone:832-595-0022
Mailing Address - Fax:832-595-8320
Practice Address - Street 1:5110 AVENUE H
Practice Address - Street 2:SUITE MO5
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-2014
Practice Address - Country:US
Practice Address - Phone:832-595-0022
Practice Address - Fax:832-595-8320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-27
Last Update Date:2014-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX195231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty