Provider Demographics
NPI:1902278484
Name:ASSOCIATES FOR DENTAL HEALTH, PLLC.
Entity Type:Organization
Organization Name:ASSOCIATES FOR DENTAL HEALTH, PLLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DONAL
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:ANDRESS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-738-1579
Mailing Address - Street 1:6137 KIRBY DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-3148
Mailing Address - Country:US
Mailing Address - Phone:281-738-1579
Mailing Address - Fax:713-490-6464
Practice Address - Street 1:5712 KIRBY DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77005-2408
Practice Address - Country:US
Practice Address - Phone:281-738-1579
Practice Address - Fax:713-490-6464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-23
Last Update Date:2015-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6626122300000X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty