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Periogoldental P.a
Dental Clinic/Center in Lake Jackson, Texas
NPI 1659507002

Periogoldental P.a is a Dental Clinic/Center based in Lake Jackson, TX and is specialized in Dental. Periogoldental P.a practices in Lake Jackson, TX. The NPI Number for Periogoldental P.a is 1659507002 and holds a License No. 20347 (Texas).

The current practice location address for Periogoldental P.a is 115 N Dixie Dr Ste 300, Lake Jackson, TX and can be reached out via phone at 979-285-9998 and via fax at 979-480-0411.

Location: 115 N Dixie Dr Ste 300, Lake Jackson, TX, 77566-5958
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1659507002
Provider Name
Periogoldental P.a
Credential
Provider Entity Type
Organization
Address
115 N Dixie Dr Ste 300, Lake Jackson, TX, 77566-5958
Phone Number
979-285-9998
Fax Number
979-480-0411
Provider Enumeration Date
05/29/2009
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
115 N Dixie Dr Ste 300
City
Lake Jackson
State
Texas
Zip
77566-5958
Phone Number
979-285-9998
Fax Number
979-480-0411
person
Provider Business Mailing Address Details
Address
115 N Dixie Dr Ste 300
City
Lake Jackson
State
Texas
Zip
77566-5958
Phone Number
979-285-9998
Fax Number
979-480-0411
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Dental
Taxonomy
261QD0000X
License No.
20347 (Texas)
Definition
Definition to come...
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