Provider Demographics
NPI:1669970950
Name:HOUSTON PEDIATRIC DENTAL PARTNERS
Entity type:Organization
Organization Name:HOUSTON PEDIATRIC DENTAL PARTNERS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RITA
Authorized Official - Middle Name:MAXINE
Authorized Official - Last Name:CAMMARATA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:713-666-7884
Mailing Address - Street 1:5252 WESTCHESTER ST STE 190
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-4144
Mailing Address - Country:US
Mailing Address - Phone:713-666-7884
Mailing Address - Fax:
Practice Address - Street 1:5252 WESTCHESTER ST STE 190
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77005-4144
Practice Address - Country:US
Practice Address - Phone:713-666-7884
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-01
Last Update Date:2018-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX187421223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty