Van De Walle Family Dentistry
Clinic/Center, Dental in San Marcos, TX. Organization (NPI-2).
NPI number1649536244
StatusActive
Last updated in NPPESJun 2, 2016
Details
- NPI
- 1649536244
- Entity type
- Organization (NPI-2)
- Legal business name
- Van De Walle Family Dentistry
- Organization subpart
- No
- Enumeration date
- Apr 9, 2012
- Last updated
- Jun 2, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | 21761 | TX | Yes |
Practice location
111 Willows Springs Dr.San Marcos, TX 78666-6076
Phone 512-878-2540
Mailing address
111 Willows Springs DrSan Marcos, TX 78666-6076
Phone 512-878-2540
Authorized official
Thomas Van De Walle
President
5128782540
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