| San Antonio Orthodontics | |
|
12315 Judson Rd Ste 218 Live Oak TX 78233-3264 | |
| (210) 656-3531 | |
| Not Available |
| Full Name | San Antonio Orthodontics |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 12315 Judson Rd Ste 218, Live Oak, Texas |
| Authorized Official Name and Position | James Vandeberg (OWNER) |
| Authorized Official Contact | 2109029122 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| San Antonio Orthodontics 8536 Alydar Cir Boerne TX 78015-4434 Ph: (210) 902-9122 | San Antonio Orthodontics 12315 Judson Rd Ste 218 Live Oak TX 78233-3264 Ph: (210) 656-3531 |
| NPI Number | 1508363698 |
|---|---|
| Provider Enumeration Date | 04/06/2018 |
| Last Update Date | 04/06/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508363698 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 23213 (Texas) | Primary |
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