Provider Demographics
NPI:1952992521
Name:FORT BEND DENTAL SLEEP MEDICINE, PLLC
Entity Type:Organization
Organization Name:FORT BEND DENTAL SLEEP MEDICINE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DWIGHT
Authorized Official - Middle Name:
Authorized Official - Last Name:PECCORA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:713-412-0189
Mailing Address - Street 1:3717 TOWNSHIP LN
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-5222
Mailing Address - Country:US
Mailing Address - Phone:281-499-3541
Mailing Address - Fax:
Practice Address - Street 1:3717 TOWNSHIP LN
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-5222
Practice Address - Country:US
Practice Address - Phone:281-499-3541
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DDS PARTNERS HOLDINGS LLLP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-01-27
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic