| Premier Dental-san Antonio, Pllc | |
|
21950 Bulverde Rd #103 San Antonio TX 78259-2144 | |
| (210) 494-8850 | |
| Not Available |
| Full Name | Premier Dental-san Antonio, Pllc |
|---|---|
| Speciality | Dentist |
| Location | 21950 Bulverde Rd, San Antonio, Texas |
| Authorized Official Name and Position | Luigi Massa (OWNER) |
| Authorized Official Contact | 2104948850 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Dental-san Antonio, Pllc 21950 Bulverde Rd #103 San Antonio TX 78259 Ph: (210) 494-8850 | Premier Dental-san Antonio, Pllc 21950 Bulverde Rd #103 San Antonio TX 78259-2144 Ph: (210) 494-8850 |
| NPI Number | 1487194486 |
|---|---|
| Provider Enumeration Date | 02/24/2017 |
| Last Update Date | 02/24/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487194486 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 22462 (Texas) | Primary |
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