Organization Name: | KATY DENTAL, INC. |
NPI Number: | 1285067298 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARTHA CATALINA VILLASENOR (OWNER) |
Mailing Address: | 3510 Hobson Rd Suite 302 Woodridge |
State: | IL US |
Postal Code: | 605171439 |
Phone Number: | 6309713626 |
Fax Number: | 6309713752 |
NPI Enumeration Date: | 08/13/2013 |
NPI Last Update Date: | 08/13/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 302R00000X |
License Number: | 019024012 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Managed Care Organizations |
Taxonomy Classification: | Health Maintenance Organization |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) A form of health insurance in which its members prepay a premium for the HMO |