Provider Demographics
NPI:1366982175
Name:PEAR MTD LLC
Entity type:Organization
Organization Name:PEAR MTD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PENCHAS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:713-322-6000
Mailing Address - Street 1:2213 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-6403
Mailing Address - Country:US
Mailing Address - Phone:713-322-6000
Mailing Address - Fax:
Practice Address - Street 1:2213 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-6403
Practice Address - Country:US
Practice Address - Phone:713-322-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-27
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX184151223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty