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General NPI Number Information
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NPI Number | 1073947461
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Entity Type | Organization
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Legal Business Name | UNDER THE SEA CHILDREN'S DENTISTRY, P.C
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Dates
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Enumeration Date | 08/21/2013
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Last Update Date | 08/22/2013
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Provider Practice Location Address
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Address Line | 8340 FM 78 SUITE #8
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City | CONVERSE
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State | TX
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Zip | 78109-1080
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Country | US
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Telephone | 210-314-1830
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Fax | 210-314-1830
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Provider Business Mailing Address
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Address Line | 24015 BRIARBROOK WAY
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City | SAN ANTONIO
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State | TX
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Zip | 78261-2686
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Country | US
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Telephone | 210-314-1830
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Fax | 210-314-1830
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Authorized Official
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Title or Position | PEDIATRIC DENTIST
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Name | DR. NATASCHA ELENA ARISMENDI SARABIA
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Credential | DDS
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Telephone | 210-862-6458
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 25587
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License Number State | TX
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