| My Local Texas Dental Practice, Pllc | |
|
1621 Pat Booker Rd Universal City TX 78148-3432 | |
| (210) 654-9094 | |
| Not Available |
| Full Name | My Local Texas Dental Practice, Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1621 Pat Booker Rd, Universal City, Texas |
| Authorized Official Name and Position | Michelle Johnson (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 5093158338 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| My Local Texas Dental Practice, Pllc 1621 Pat Booker Rd Universal City TX 78148-3432 Ph: (210) 654-9094 | My Local Texas Dental Practice, Pllc 1621 Pat Booker Rd Universal City TX 78148-3432 Ph: (210) 654-9094 |
| NPI Number | 1770150682 |
|---|---|
| Provider Enumeration Date | 06/09/2021 |
| Last Update Date | 06/09/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770150682 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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