| Texas Dental Specialist Practice, Pllc | |
|
17230 Autry Pond Rd Ste 115 San Antonio TX 78247-2097 | |
| (210) 396-7667 | |
| Not Available |
| Full Name | Texas Dental Specialist Practice, Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 17230 Autry Pond Rd Ste 115, San Antonio, Texas |
| Authorized Official Name and Position | Gregory Kostelac (DATA ANALYST) |
| Authorized Official Contact | 7193725605 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Texas Dental Specialist Practice, Pllc 6110 Barnes Rd Colorado Springs CO 80922-2600 Ph: () - | Texas Dental Specialist Practice, Pllc 17230 Autry Pond Rd Ste 115 San Antonio TX 78247-2097 Ph: (210) 396-7667 |
| NPI Number | 1093457012 |
|---|---|
| Provider Enumeration Date | 04/11/2022 |
| Last Update Date | 04/11/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093457012 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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