Provider Demographics
NPI:1881923779
Name:PERFECT DENTAL PA
Entity type:Organization
Organization Name:PERFECT DENTAL PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:SABETI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-359-3636
Mailing Address - Street 1:4040 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77087-4713
Mailing Address - Country:US
Mailing Address - Phone:713-645-1680
Mailing Address - Fax:713-645-1685
Practice Address - Street 1:4040 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77087-4713
Practice Address - Country:US
Practice Address - Phone:713-645-1680
Practice Address - Fax:713-645-1685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-23
Last Update Date:2009-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX173001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty