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General NPI Number Information
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NPI Number | 1124581905
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Entity Type | Organization
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Legal Business Name | SCOTT A. JANSE, D.D.S., M.S., P.A.
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Dates
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Enumeration Date | 04/09/2019
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Last Update Date | 04/09/2019
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Provider Practice Location Address
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Address Line | 1014 PARIS ST STE C
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City | CASTROVILLE
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State | TX
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Zip | 78009-2956
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Country | US
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Telephone | 830-538-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 601 NW LOOP 410 STE 455
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City | SAN ANTONIO
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State | TX
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Zip | 78216-5511
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Country | US
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Telephone | 210-342-2444
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Fax | 210-342-2443
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Authorized Official
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Title or Position | OWNER
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Name | SCOTT A JANSE
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Credential | DDS
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Telephone | 210-342-2444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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