Provider Demographics
NPI:1851687263
Name:ALBRITTON & GOMEZ DENTAL ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:ALBRITTON & GOMEZ DENTAL ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER (PARTNERS)
Authorized Official - Prefix:
Authorized Official - First Name:GERZAIN
Authorized Official - Middle Name:WHITNEY
Authorized Official - Last Name:GOMEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:409-727-6453
Mailing Address - Street 1:1320 FRANKLIN AVE.
Mailing Address - Street 2:
Mailing Address - City:NEDERLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77627-3949
Mailing Address - Country:US
Mailing Address - Phone:409-727-6453
Mailing Address - Fax:409-722-4322
Practice Address - Street 1:1320 FRANKLIN AVE.
Practice Address - Street 2:
Practice Address - City:NEDERLAND
Practice Address - State:TX
Practice Address - Zip Code:77627-3949
Practice Address - Country:US
Practice Address - Phone:409-727-6453
Practice Address - Fax:409-722-4322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-23
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX246511223G0001X
TX153811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty