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General NPI Number Information
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NPI Number | 1669563243
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Entity Type | Organization
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Legal Business Name | THOMAS DMD & CUMBERBATCH DDS, P.A. DBA BAYTOWN GENTLE DENTAL CENTER
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3700 EMMET HUTTO BLVD
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City | BAYTOWN
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State | TX
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Zip | 77521-1764
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Country | US
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Telephone | 281-837-9122
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Fax | 281-837-6009
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Provider Business Mailing Address
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Address Line | 3700 EMMET HUTTO BLVD
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City | BAYTOWN
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State | TX
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Zip | 77521-1764
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Country | US
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Telephone | 281-837-9122
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Fax | 281-837-6009
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Authorized Official
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Title or Position | ACCOUNT MANAGER
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Name | TRACIE CREDEUR
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Credential |
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Telephone | 281-837-9122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 18921
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License Number State | TX
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