Provider First Line Business Practice Location Address:
7037 CAPITOL
Provider Second Line Business Practice Location Address:
MAGNOLIA DENTAL CLINIC
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77011
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-928-9550
Provider Business Practice Location Address Fax Number:
713-928-9830
Provider Enumeration Date:
02/20/2007