Provider Demographics
NPI:1902666944
Name:FORT BEND DENTAL ALIANA, PLLC
Entity Type:Organization
Organization Name:FORT BEND DENTAL ALIANA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DWIGHT
Authorized Official - Middle Name:D
Authorized Official - Last Name:PECCORA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-499-3541
Mailing Address - Street 1:16647 W AIRPORT BLVD
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16647 W AIRPORT BLVD
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77498
Practice Address - Country:US
Practice Address - Phone:281-524-3575
Practice Address - Fax:281-605-5956
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-19
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty