Provider Demographics
NPI:1942341128
Name:FLEURY, JILL MARIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:JILL
Middle Name:MARIA
Last Name:FLEURY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12002 COSTA DEL REY CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77041-5742
Mailing Address - Country:US
Mailing Address - Phone:713-818-6291
Mailing Address - Fax:
Practice Address - Street 1:14925 MEMORIAL DR
Practice Address - Street 2:SUITE 102
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-5136
Practice Address - Country:US
Practice Address - Phone:281-558-8888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX209531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice