Provider Demographics
NPI:1710005368
Name:CLARENCE E. MUSSLEWHITE JR. DDS INC
Entity Type:Organization
Organization Name:CLARENCE E. MUSSLEWHITE JR. DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:C
Authorized Official - Middle Name:E
Authorized Official - Last Name:MUSSLEWHITE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:713-827-8200
Mailing Address - Street 1:12727 KIMBERLEY LN
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-4047
Mailing Address - Country:US
Mailing Address - Phone:713-827-8200
Mailing Address - Fax:713-827-8567
Practice Address - Street 1:12727 KIMBERLEY LN
Practice Address - Street 2:SUITE 101
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-4047
Practice Address - Country:US
Practice Address - Phone:713-827-8200
Practice Address - Fax:713-827-8567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty