Provider Demographics
NPI:1891944336
Name:C.D. CANTU D.D.S. INC
Entity Type:Organization
Organization Name:C.D. CANTU D.D.S. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PRACTICE DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:DONALD
Authorized Official - Last Name:CANTU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:713-926-5144
Mailing Address - Street 1:7444 HARRISBURG BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77011-4741
Mailing Address - Country:US
Mailing Address - Phone:713-926-5144
Mailing Address - Fax:713-926-5235
Practice Address - Street 1:7444 HARRISBURG BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77011-4741
Practice Address - Country:US
Practice Address - Phone:713-926-5144
Practice Address - Fax:713-926-5235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-09
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX94331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB09433-01Medicaid