London Brazil
Dentist in San Antonio, TX. Individual provider (NPI-1).
NPI number1649686239
StatusActive
Last updated in NPPESJul 3, 2014
Details
- NPI
- 1649686239
- Entity type
- Individual (NPI-1)
- Name
- London Brazil
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 3, 2014
- Last updated
- Jul 3, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 30198 | TX | Yes |
Practice location
819 Camden StSan Antonio, TX 78215-1446
Phone 409-313-4789
Mailing address
819 Camden StSan Antonio, TX 78215-1446
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