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General NPI Number Information
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NPI Number | 1396853131
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Entity Type | Organization
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Legal Business Name | HERMIONE A WHITE DDS PC
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 13050 LOUETTA RD #216
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City | CYPRESS
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State | TX
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Zip | 77429-5215
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Country | US
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Telephone | 281-376-0122
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Fax | 281-376-2472
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Provider Business Mailing Address
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Address Line | 13615 PRISTINE LAKE LN
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City | CYPRESS
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State | TX
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Zip | 77429-6010
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Country | US
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Telephone | 281-376-0122
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Fax | 281-376-2472
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | MRS. HERMIONE A WHITE
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Credential | DDS
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Telephone | 281-376-0122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 15219
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License Number State | TX
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