Provider Demographics
NPI:1427055292
Name:PERIO HEALTH PROFESSIONALS, PLLC
Entity type:Organization
Organization Name:PERIO HEALTH PROFESSIONALS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:KENT
Authorized Official - Last Name:MCGUIRE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:713-783-5442
Mailing Address - Street 1:3400 S GESSNER RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-7247
Mailing Address - Country:US
Mailing Address - Phone:713-783-5442
Mailing Address - Fax:713-952-0614
Practice Address - Street 1:3400 S GESSNER RD
Practice Address - Street 2:SUITE 102
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-7247
Practice Address - Country:US
Practice Address - Phone:713-783-5442
Practice Address - Fax:713-952-0614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX115681223P0300X
TX204051223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty