Provider Demographics
NPI:1851849111
Name:NOW DENTAL
Entity Type:Organization
Organization Name:NOW DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAXIM
Authorized Official - Middle Name:
Authorized Official - Last Name:SKORMIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:832-932-3959
Mailing Address - Street 1:1001 S EGRET BAY BLVD
Mailing Address - Street 2:SUITE # 201
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-5799
Mailing Address - Country:US
Mailing Address - Phone:832-932-3959
Mailing Address - Fax:832-932-3198
Practice Address - Street 1:1001 S EGRET BAY BLVD
Practice Address - Street 2:SUITE # 201
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-5799
Practice Address - Country:US
Practice Address - Phone:832-932-3959
Practice Address - Fax:832-932-3198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-15
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX28857122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1003955378Medicaid