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General NPI Number Information
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NPI Number | 1124725353
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Entity Type | Organization
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Legal Business Name | LITTLE BITE DENTAL CARE, PLLC
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Dates
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Enumeration Date | 02/08/2023
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Last Update Date | 02/28/2023
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Provider Practice Location Address
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Address Line | 4522 S RAUL LONGORIA RD
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City | EDINBURG
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State | TX
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Zip | 78542-2218
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Country | US
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Telephone | 956-929-0500
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Fax |
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Provider Business Mailing Address
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Address Line | 5003 AUGUST CT
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City | EDINBURG
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State | TX
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Zip | 78539-0244
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Country | US
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Telephone | 956-929-0500
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MR. RICHARD AGNERO
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Credential |
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Telephone | 956-929-0500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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