Provider Demographics
NPI:1700521085
Name:SUGAR LAND DENTAL IMPLANTS ASSOCIATES, PLLC
Entity type:Organization
Organization Name:SUGAR LAND DENTAL IMPLANTS ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR./OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:VEGA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-262-3030
Mailing Address - Street 1:15555 CREEK BEND DR STE 100
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4670
Mailing Address - Country:US
Mailing Address - Phone:281-262-3030
Mailing Address - Fax:281-207-0766
Practice Address - Street 1:15555 CREEK BEND DR STE 100
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4670
Practice Address - Country:US
Practice Address - Phone:281-262-3030
Practice Address - Fax:281-207-0766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-02
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental