Provider Demographics
NPI:1578789095
Name:MAXWELLO INC.
Entity Type:Organization
Organization Name:MAXWELLO INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LETITIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PLUMMER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:713-436-2522
Mailing Address - Street 1:10223 BROADWAY ST
Mailing Address - Street 2:SUITE D-1
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7881
Mailing Address - Country:US
Mailing Address - Phone:713-436-2522
Mailing Address - Fax:713-436-2452
Practice Address - Street 1:10223 BROADWAY ST
Practice Address - Street 2:SUITE D-1
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-7880
Practice Address - Country:US
Practice Address - Phone:713-436-2522
Practice Address - Fax:713-436-2452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX 200001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty