Provider Demographics
NPI:1992933949
Name:KITTRELL, CHRISTY STEWART (RDH)
Entity type:Individual
Prefix:MRS
First Name:CHRISTY
Middle Name:STEWART
Last Name:KITTRELL
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9050 HIGHWAY 6
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-6055
Mailing Address - Country:US
Mailing Address - Phone:281-778-0034
Mailing Address - Fax:281-778-6152
Practice Address - Street 1:9050 HIGHWAY 6
Practice Address - Street 2:SUITE 100
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-6055
Practice Address - Country:US
Practice Address - Phone:281-778-0034
Practice Address - Fax:281-778-6152
Is Sole Proprietor?:No
Enumeration Date:2009-06-29
Last Update Date:2009-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15721124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist