Provider Demographics
NPI:1194476556
Name:DENTISTRY OF KINGWOOD, PLLC
Entity type:Organization
Organization Name:DENTISTRY OF KINGWOOD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PIERRE
Authorized Official - Middle Name:MINA
Authorized Official - Last Name:GHATTAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-358-2191
Mailing Address - Street 1:1520 GREEN OAK PL STE B
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-2489
Mailing Address - Country:US
Mailing Address - Phone:281-358-2191
Mailing Address - Fax:281-358-0417
Practice Address - Street 1:1520 GREEN OAK PL STE B
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-2489
Practice Address - Country:US
Practice Address - Phone:281-358-2191
Practice Address - Fax:281-358-0417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-17
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental