| NPI | 1689684417 |
|---|---|
| Doing Business As | ICON DENTAL CENTER |
| Entity Type | Organization |
| Authorized Contact | LEON FOREMAN Owner 713-266-2929 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: TX 21521) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 21095) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 23589) | |
| 1223G0001X Dentist, General Practice (Licence: TX 21521) | |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2011-09-14 |