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General NPI Number Information
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NPI Number | 1073398566
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Entity Type | Organization
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Legal Business Name | TEXAS LITTLE TEETH PEDIATRIC DENTISTRY
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Dates
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Enumeration Date | 08/31/2023
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Last Update Date | 01/18/2024
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Provider Practice Location Address
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Address Line | 12412 S KIRKWOOD RD
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City | STAFFORD
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State | TX
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Zip | 77477-2835
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Country | US
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Telephone | 832-899-4995
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Fax |
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Provider Business Mailing Address
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Address Line | 12412 S KIRKWOOD RD
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City | STAFFORD
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State | TX
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Zip | 77477-2835
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Country | US
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Telephone | 832-899-4995
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Fax |
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Authorized Official
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Title or Position | LEAD PEDIATRIC DENTIST
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Name | DR. SHIPRA SHARMA
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Credential |
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Telephone | 858-847-8525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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