Provider Demographics
NPI:1457782419
Name:ESTEEM DENTAL STONE PARK
Entity Type:Organization
Organization Name:ESTEEM DENTAL STONE PARK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:832-349-6286
Mailing Address - Street 1:PO BOX 84703
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-0010
Mailing Address - Country:US
Mailing Address - Phone:281-459-1541
Mailing Address - Fax:
Practice Address - Street 1:5810 E SAM HOUSTON PKWY N
Practice Address - Street 2:STE L
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77049-2528
Practice Address - Country:US
Practice Address - Phone:281-459-1541
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-02
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX258441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty