Provider Demographics
NPI:1992291991
Name:MOLAR BEAR PEDIATRIC DENTISTRY, PLLC
Entity type:Organization
Organization Name:MOLAR BEAR PEDIATRIC DENTISTRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:GASCOYNE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-859-9878
Mailing Address - Street 1:16125 CAIRNWAY DR STE 108
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-3556
Mailing Address - Country:US
Mailing Address - Phone:281-859-9878
Mailing Address - Fax:281-345-9734
Practice Address - Street 1:16125 CAIRNWAY DR STE 108
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-3556
Practice Address - Country:US
Practice Address - Phone:281-859-9878
Practice Address - Fax:281-345-9734
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-03
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty