Provider Demographics
NPI:1912212259
Name:SEVEN MEADOWS DENTAL
Entity type:Organization
Organization Name:SEVEN MEADOWS DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:C
Authorized Official - Last Name:FILLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-693-0475
Mailing Address - Street 1:23108 SEVEN MEADOWS PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-0256
Mailing Address - Country:US
Mailing Address - Phone:281-693-0475
Mailing Address - Fax:281-693-0479
Practice Address - Street 1:23108 SEVEN MEADOWS PKWY STE 200
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-0256
Practice Address - Country:US
Practice Address - Phone:281-693-0475
Practice Address - Fax:281-693-0479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-11
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX212961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty