Healthcare Provider Details

I. General information

NPI: 1417229410
Provider Name (Legal Business Name): HUMBERTO ARTURO SOTO D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2012
Last Update Date: 11/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE ALLENDE #840 COLONIA CENTRO
REYNOSA TAMAULIPAS
88500
MX

IV. Provider business mailing address

701 N INTERNATIONAL BLVD STE 101-1327
HIDALGO TX
78557-2582
US

V. Phone/Fax

Practice location:
  • Phone: 528999221625
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number7777808
License Number StateZZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: