Organization
BLOSSOM ORTHODONTICS AND PEDIATRIC DENTISTRY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHUNDA THOMPSON DDS (OWNER)
(281) 359-5551
Entity
Organization
Contact information
Practice address
13119 LOUETTA RD, CYPRESS, TX 77429-5155
(281) 359-5551
Mailing address
134 VINTAGE PARK BLVD, SUITE A 109, HOUSTON, TX 77070-3998
(281) 359-5551
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
—
—
1223P0300X
Periodontics
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
02/16/2016
Last updated
02/16/2016
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