Provider Demographics
NPI:1871060715
Name:A.S PROSTHODONTICS PLLC
Entity type:Organization
Organization Name:A.S PROSTHODONTICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SADER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-596-0046
Mailing Address - Street 1:7710 FRY RD STE 700
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-7335
Mailing Address - Country:US
Mailing Address - Phone:832-596-0046
Mailing Address - Fax:
Practice Address - Street 1:7710 FRY RD STE 700
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-7335
Practice Address - Country:US
Practice Address - Phone:832-596-0046
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-29
Last Update Date:2018-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty