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General NPI Number Information
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NPI Number | 1144599531
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Entity Type | Organization
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Legal Business Name | CELE POKORNEY DDS PLLC
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Dates
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Enumeration Date | 12/14/2011
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Last Update Date | 12/14/2011
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Provider Practice Location Address
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Address Line | 10865 SHAENFIELD RD SUITE #1111
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City | SAN ANTONIO
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State | TX
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Zip | 78254-9601
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Country | US
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Telephone | 210-549-1011
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Fax |
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Provider Business Mailing Address
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Address Line | 10865 SHAENFIELD RD SUITE #1111
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City | SAN ANTONIO
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State | TX
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Zip | 78254-9601
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Country | US
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Telephone | 210-549-1011
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Fax |
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Authorized Official
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Title or Position | OWNER/ORTHODONTIST
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Name | DR. CELESTE OLIVER
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Credential | DDS, DHSC
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Telephone | 21054910111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 25312
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License Number State | TX
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