Provider Demographics
NPI:1851109250
Name:PRIME DENTAL CARE USA SPRING TEXAS PLLC
Entity type:Organization
Organization Name:PRIME DENTAL CARE USA SPRING TEXAS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWER/PRESIDENT/CEO/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:FADY
Authorized Official - Middle Name:N
Authorized Official - Last Name:GUIRGUIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:917-602-3213
Mailing Address - Street 1:25114 GROGANS MILL RD STE D
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77380-2360
Mailing Address - Country:US
Mailing Address - Phone:832-650-0553
Mailing Address - Fax:
Practice Address - Street 1:25114 GROGANS MILL RD STE D
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77380-2360
Practice Address - Country:US
Practice Address - Phone:832-650-0553
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty