Healthcare Provider Details

I. General information

NPI: 1730124694
Provider Name (Legal Business Name): CLAUDIA I CONTRERAS DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 06/09/2021
Certification Date: 06/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8210 FLOYD CURL DR
SAN ANTONIO TX
78229-3923
US

IV. Provider business mailing address

P.O. BOX 40397
SAN ANTONIO TX
78229-3900
US

V. Phone/Fax

Practice location:
  • Phone: 210-450-3500
  • Fax: 210-567-2844
Mailing address:
  • Phone: 210-567-3274
  • Fax: 210-567-2844

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberF22516
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number22516
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: