| Tooth Acres Inc | |
|
2635 Nacogdoches Rd San Antonio TX 78217 | |
| (210) 829-7651 | |
| (210) 829-4604 |
| Full Name | Tooth Acres Inc |
|---|---|
| Speciality | Dentist |
| Location | 2635 Nacogdoches Rd, San Antonio, Texas |
| Authorized Official Name and Position | Barry Weyman Holleron (PRESIDENT) |
| Authorized Official Contact | 2108297651 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tooth Acres Inc 2635 Nacogdoches Rd San Antonio TX 78217 Ph: (210) 829-7651 | Tooth Acres Inc 2635 Nacogdoches Rd San Antonio TX 78217 Ph: (210) 829-7651 |
| NPI Number | 1306958020 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306958020 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 14065 (Texas) | Primary |
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