Provider Demographics
NPI:1245819671
Name:PARK DENTISTRY FOR KIDS SIENNA, PLLC
Entity type:Organization
Organization Name:PARK DENTISTRY FOR KIDS SIENNA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:DANIELLE
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:713-993-7332
Mailing Address - Street 1:2651 KIPLING ST APT 1712
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-1558
Mailing Address - Country:US
Mailing Address - Phone:713-993-7332
Mailing Address - Fax:
Practice Address - Street 1:4417 SIENNA PKWY STE 200
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-5900
Practice Address - Country:US
Practice Address - Phone:713-993-7332
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-04
Last Update Date:2021-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental