Jet Dental Of San Antonio, PLLC
Clinic/Center, Dental in San Antonio, TX. Organization (NPI-2).
NPI number1396617536
StatusActive
Last updated in NPPESSep 18, 2025
Details
- NPI
- 1396617536
- Entity type
- Organization (NPI-2)
- Legal business name
- Jet Dental Of San Antonio, PLLC
- Organization subpart
- No
- Enumeration date
- Sep 18, 2025
- Certification date
- Sep 18, 2025
- Last updated
- Sep 18, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | – | – | Yes |
Practice location
1 Lone Star Pass Ste 46San Antonio, TX 78264-3650
Phone 801-430-9262
Mailing address
1 Lone Star Pass Ste 46San Antonio, TX 78264-3650
Phone 801-430-9262
Authorized official
Jeffrey Dane Johnson
Owner
8015928829
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