Provider Demographics
NPI:1790240794
Name:JAMBOREE DENTISTRY VI PLLC
Entity Type:Organization
Organization Name:JAMBOREE DENTISTRY VI PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:T
Authorized Official - Last Name:SPIGER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:832-930-7850
Mailing Address - Street 1:6715 BISSONNET ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-6129
Mailing Address - Country:US
Mailing Address - Phone:832-930-7850
Mailing Address - Fax:832-930-7851
Practice Address - Street 1:6715 BISSONNET ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-6129
Practice Address - Country:US
Practice Address - Phone:832-930-7850
Practice Address - Fax:832-930-7851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-04
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223D0001XDental ProvidersDentistDental Public HealthGroup - Multi-Specialty