Provider Demographics
NPI:1851981971
Name:T. H. WINDERMERE DENTAL CARE PLLC
Entity Type:Organization
Organization Name:T. H. WINDERMERE DENTAL CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEREDITH
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:MOSIER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-974-0833
Mailing Address - Street 1:3115 S LAMAR BLVD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-5803
Mailing Address - Country:US
Mailing Address - Phone:512-640-4090
Mailing Address - Fax:
Practice Address - Street 1:3115 S LAMAR BLVD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-5803
Practice Address - Country:US
Practice Address - Phone:512-640-4090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-22
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental