Provider First Line Business Practice Location Address:
UNIVERSITY OF TEXAS DENTAL BRANCH
Provider Second Line Business Practice Location Address:
6516 M D ANDERSON BLVD # 370
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77030
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-500-4119
Provider Business Practice Location Address Fax Number:
713-500-4123
Provider Enumeration Date:
03/20/2007