Healthcare Provider Details

I. General information

NPI: 1447223623
Provider Name (Legal Business Name): JOSEPH PHILIP FRENO JR. DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12042 BLANCO RD SUITE 300
SAN ANTONIO TX
78216-5440
US

IV. Provider business mailing address

12042 BLANCO RD SUITE 300
SAN ANTONIO TX
78216-5440
US

V. Phone/Fax

Practice location:
  • Phone: 210-349-9800
  • Fax: 210-349-9811
Mailing address:
  • Phone: 210-349-9800
  • Fax: 210-349-9811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number18455
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: