| Sonterra Oral And Maxillofacial Surgery Center | |
|
1202 East Sonterra Blvd Suite 801 San Antonio TN 78258 | |
| (210) 494-2005 | |
| (210) 494-1332 |
| Full Name | Sonterra Oral And Maxillofacial Surgery Center |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 1202 East Sonterra Blvd, San Antonio, Tennessee |
| Authorized Official Name and Position | Robert Bryan Roach (ORAL SURGEON) |
| Authorized Official Contact | 2104942005 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sonterra Oral And Maxillofacial Surgery Center 1202 East Sonterra Blvd Suite 801 San Antonio TN 78258 Ph: (210) 494-2005 | Sonterra Oral And Maxillofacial Surgery Center 1202 East Sonterra Blvd Suite 801 San Antonio TN 78258 Ph: (210) 494-2005 |
| NPI Number | 1972709343 |
|---|---|
| Provider Enumeration Date | 06/22/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972709343 | NPI | - | NPPES |
| 1134188576 | Other | NPI PROVIDER | |
| 1972562312 | Other | NPI PROVIDER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 22140 (Texas) | Primary |
Sonterra Oral And Maxillofacial Surgery Center Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1202 East Sonterra Blvd, Suite 801, San Antonio, TN 78258 Phone: 210-494-2005 Fax: 210-494-1332 |