West Culebra Dental PLLC
Dentist, General Practice in San Antonio, TX. Organization (NPI-2).
NPI number1144604166
StatusActive
Last updated in NPPESJul 20, 2015
Details
- NPI
- 1144604166
- Entity type
- Organization (NPI-2)
- Legal business name
- West Culebra Dental PLLC
- Organization subpart
- No
- Enumeration date
- Jul 20, 2015
- Last updated
- Jul 20, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 26562 | TX | Yes |
Practice location
5835 Culebra RdSuite 105
San Antonio, TX 78228-4354
Phone 940-368-1495
Mailing address
1308 Teasley LnDenton, TX 76205-7946
Phone 254-717-8469
Authorized official
Darren Earl Boggs
Chief Operating Officer
9403681495
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