Pax Dental
Clinic/Center, Dental in San Antonio, TX. Organization (NPI-2).
NPI number1003512005
StatusActive
Last updated in NPPESFeb 1, 2023
Details
- NPI
- 1003512005
- Entity type
- Organization (NPI-2)
- Legal business name
- Pax Dental
- Organization subpart
- No
- Enumeration date
- Feb 1, 2023
- Certification date
- Feb 1, 2023
- Last updated
- Feb 1, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | – | – | Yes |
Other names
- Pax Dental (Doing Business As)
Practice location
5311 N Loop 1604 W Ste 123San Antonio, TX 78249-4392
Phone 210-276-0600
Mailing address
11327 Expo Blvd Apt 308San Antonio, TX 78230-1739
Phone 210-454-1997
Authorized official
Nicolas John Richards
Owner Dentist
2104541997
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