| Mysa Dental | |
|
13762 Potranco Rd Ste 105 San Antonio TX 78253-4047 | |
| (210) 564-9044 | |
| (210) 564-9088 |
| Full Name | Mysa Dental |
|---|---|
| Speciality | Clinic/Center |
| Location | 13762 Potranco Rd Ste 105, San Antonio, Texas |
| Authorized Official Name and Position | Khushbu Malhotra (DENTIST) |
| Authorized Official Contact | 6178344646 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mysa Dental 10615 Ysamy Way San Antonio TX 78213-1659 Ph: (617) 834-4646 | Mysa Dental 13762 Potranco Rd Ste 105 San Antonio TX 78253-4047 Ph: (210) 564-9044 |
| NPI Number | 1710587431 |
|---|---|
| Provider Enumeration Date | 10/30/2020 |
| Last Update Date | 05/15/2023 |
| Medicare PECOS PAC ID | 1355759705 |
|---|---|
| Medicare Enrollment ID | O20210423000279 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710587431 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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