Provider Demographics
NPI:1134583511
Name:DENTAL 4U
Entity type:Organization
Organization Name:DENTAL 4U
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARITZA
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLALTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-681-1171
Mailing Address - Street 1:5901 WESTHEIMER RD STE D
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-7607
Mailing Address - Country:US
Mailing Address - Phone:713-636-9510
Mailing Address - Fax:832-991-8108
Practice Address - Street 1:5901 WESTHEIMER RD STE D
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-7607
Practice Address - Country:US
Practice Address - Phone:713-636-9510
Practice Address - Fax:832-991-8108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-11
Last Update Date:2016-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty