Provider Demographics
NPI:1568688612
Name:MCCANDLESS, GEORGANNE (DDS)
Entity Type:Individual
Prefix:DR
First Name:GEORGANNE
Middle Name:
Last Name:MCCANDLESS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 SCHOOL ST
Mailing Address - Street 2:SUITE 42
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-4593
Mailing Address - Country:US
Mailing Address - Phone:281-516-2700
Mailing Address - Fax:281-516-2701
Practice Address - Street 1:455 SCHOOL ST
Practice Address - Street 2:SUITE 42
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-4593
Practice Address - Country:US
Practice Address - Phone:281-516-2700
Practice Address - Fax:281-516-2701
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX192101223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry