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General NPI Number Information
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NPI Number | 1952934176
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Entity Type | Organization
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Legal Business Name | ATASCOCITA CONTEMPORARY DENTISTRY AND ORTHODONTICS PC
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Dates
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Enumeration Date | 02/17/2020
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Last Update Date | 02/17/2020
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Provider Practice Location Address
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Address Line | 6730 ATASCOCITA RD STE 111
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City | HUMBLE
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State | TX
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Zip | 77346-1995
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Country | US
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Telephone | 281-359-5551
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Fax | 281-359-5516
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Provider Business Mailing Address
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Address Line | 134 VINTAGE PARK BLVD STE ABOX14
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City | HOUSTON
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State | TX
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Zip | 77070-3998
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | SHUNDA THOMPSON
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Credential | DDS
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Telephone | 281-359-5551
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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 |
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License Number State |
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