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General NPI Number Information
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NPI Number | 1023483062
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Entity Type | Organization
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Legal Business Name | NEW HEIGHTS DENTAL AND BRACES PA
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Dates
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Enumeration Date | 12/02/2015
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Last Update Date | 12/02/2015
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Provider Practice Location Address
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Address Line | 7700 BROADWAY ST SUITE 102
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City | SAN ANTONIO
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State | TX
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Zip | 78209-3232
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Country | US
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Telephone | 210-828-5300
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Fax | 210-828-3205
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Provider Business Mailing Address
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Address Line | 7700 BROADWAY ST SUITE 102
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City | SAN ANTONIO
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State | TX
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Zip | 78209-3232
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Country | US
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Telephone | 210-828-5300
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Fax | 210-828-3205
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Authorized Official
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Title or Position | OWNER/ OPERATOR
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Name | DANIEL A RILEY
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Credential | D.M.D.
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Telephone | 210-828-5300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 18101
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License Number State | TX
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