Provider First Line Business Practice Location Address:
2002 HOLCOMBE BLVD
Provider Second Line Business Practice Location Address:
160 OCL DENTAL
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77030-4211
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-791-1414
Provider Business Practice Location Address Fax Number:
713-794-7640
Provider Enumeration Date:
10/04/2006