Provider Demographics
NPI:1821301284
Name:AESTHETIC DENTISTRY ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:AESTHETIC DENTISTRY ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER & DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:UMANSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-446-4700
Mailing Address - Street 1:6818 ATASCOCITA RD
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-2817
Mailing Address - Country:US
Mailing Address - Phone:281-446-4700
Mailing Address - Fax:281-446-5398
Practice Address - Street 1:6818 ATASCOCITA RD
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-2817
Practice Address - Country:US
Practice Address - Phone:281-446-4700
Practice Address - Fax:281-446-5398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-14
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX208391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty