Provider Demographics
NPI:1396595724
Name:WHITENING MOORE SMILES DENTAL, PLLC
Entity type:Organization
Organization Name:WHITENING MOORE SMILES DENTAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LABREIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:832-713-0384
Mailing Address - Street 1:18714 N BIRCH LN
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-3414
Mailing Address - Country:US
Mailing Address - Phone:832-713-0384
Mailing Address - Fax:
Practice Address - Street 1:10122 LONG POINT RD STE 104
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77043-4319
Practice Address - Country:US
Practice Address - Phone:713-589-3993
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental