Provider Demographics
NPI:1306299730
Name:EAST WEST DENTISTS, PLLC
Entity type:Organization
Organization Name:EAST WEST DENTISTS, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:GARZA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:713-503-8056
Mailing Address - Street 1:14034 GRANT RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-1346
Mailing Address - Country:US
Mailing Address - Phone:713-714-7630
Mailing Address - Fax:
Practice Address - Street 1:14034 GRANT RD
Practice Address - Street 2:SUITE 140
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-1346
Practice Address - Country:US
Practice Address - Phone:713-714-7630
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-20
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX272111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty