Provider Demographics
NPI:1780257089
Name:GREATER HOUSTON PEDIATRIC DENTISTRY - HUMBLE, PLLC
Entity type:Organization
Organization Name:GREATER HOUSTON PEDIATRIC DENTISTRY - HUMBLE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LINH
Authorized Official - Middle Name:
Authorized Official - Last Name:LUU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-852-1191
Mailing Address - Street 1:7810 FM 1960 RD E STE 101
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-2252
Mailing Address - Country:US
Mailing Address - Phone:281-852-1191
Mailing Address - Fax:
Practice Address - Street 1:7810 FM 1960 RD E STE 101
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-2252
Practice Address - Country:US
Practice Address - Phone:281-852-1191
Practice Address - Fax:281-852-0831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-23
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty