Provider Demographics
NPI:1114590619
Name:UR SMILE DENTAL OF CLUTE PLLC
Entity Type:Organization
Organization Name:UR SMILE DENTAL OF CLUTE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:HANUMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GADE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:713-679-8986
Mailing Address - Street 1:19875 SOUTHWEST FWY STE 120
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-6721
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:105 DIXIE DR STE A
Practice Address - Street 2:
Practice Address - City:CLUTE
Practice Address - State:TX
Practice Address - Zip Code:77531-5105
Practice Address - Country:US
Practice Address - Phone:713-679-8986
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-21
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental