Individual
CHRISTINE WHITAKER FORDTRAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3507 COVEY TRAIL DR, MISSOURI CITY, TX 77459-3003
(713) 894-6079
Mailing address
3507 COVEY TRAIL DR, MISSOURI CITY, TX 77459-3003
(713) 894-6079
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
12789
TX
124Q00000X
Dental Hygienist
DH.002025133
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12789
DENTAL HYGIENE PRACTITIONER LICENSE
TX
01
—
DH.002025133
REGISTERED DENTAL HYGIENE PRACTITIONER LICENSE
CO
Enumeration date
05/07/2020
Last updated
04/27/2023
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