Provider Demographics
NPI:1184934150
Name:CONTEMPORARY ENDODONTICS PLLC.
Entity type:Organization
Organization Name:CONTEMPORARY ENDODONTICS PLLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-620-8542
Mailing Address - Street 1:1990 POST OAK BLVD
Mailing Address - Street 2:SUITE H
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-3818
Mailing Address - Country:US
Mailing Address - Phone:214-205-4569
Mailing Address - Fax:281-617-2084
Practice Address - Street 1:1990 POST OAK BLVD
Practice Address - Street 2:SUITE H
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-3818
Practice Address - Country:US
Practice Address - Phone:215-205-4569
Practice Address - Fax:281-617-2084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-08
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22550261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental