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General NPI Number Information
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NPI Number | 1104428622
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Entity Type | Organization
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Legal Business Name | TM2 DENTAL ,PLLC
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Dates
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Enumeration Date | 11/10/2020
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Last Update Date | 11/22/2022
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Provider Practice Location Address
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Address Line | 21477 STATE HIGHWAY 46 W STE 101
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City | SPRING BRANCH
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State | TX
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Zip | 78070-6797
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Country | US
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Telephone | 830-438-2121
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Fax | 830-438-2121
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Provider Business Mailing Address
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Address Line | 21477 STATE HIGHWAY 46 W STE 101
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City | SPRING BRANCH
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State | TX
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Zip | 78070-6797
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Country | US
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Telephone | 830-438-2121
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Fax | 830-438-2121
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MARISA ANTOINETTE HOLDER
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Credential |
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Telephone | 830-438-2121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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