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General NPI Number Information
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NPI Number | 1174929459
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Entity Type | Organization
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Legal Business Name | U TOO DENTAL
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Dates
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Enumeration Date | 11/13/2014
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Last Update Date | 11/14/2014
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Provider Practice Location Address
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Address Line | 3543 ROOSEVELT AVE
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City | SAN ANTONIO
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State | TX
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Zip | 78214-2832
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Country | US
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Telephone | 210-922-3232
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Fax | 210-932-2168
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Provider Business Mailing Address
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Address Line | 3543 ROOSEVELT AVE
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City | SAN ANTONIO
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State | TX
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Zip | 78214-2832
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Country | US
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Telephone | 210-922-3232
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Fax | 210-932-2168
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Authorized Official
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Title or Position | OWNER/DOCTOR
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Name | DR. SCOTT MALONE
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Credential | DDS
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Telephone | 210-922-3232
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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 |
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License Number State |
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Taxonomy #2
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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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