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Organization

SPROUT PEDIATRIC DENTISTRY, PINC

Active
Other names
Sprout Pediatric Dentistry, Inc
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SHUNDA L THOMPSON DDS (OWNER)
(800) 764-1829
Entity
Organization

Contact information

Practice address
9659 N SAM HOUSTON PKWY E, SUITE 103, HUMBLE, TX 77396-1529
(800) 764-1829
Mailing address
9659 N SAM HOUSTON PKWY E, SUITE 103, HUMBLE, TX 77396-1529
(800) 764-1829

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
24833
TX
1223P0221X
Pediatric Dentistry
Primary
24833
TX
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
23564
TX

Other

Enumeration date
05/02/2012
Last updated
05/02/2012
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