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General NPI Number Information
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NPI Number | 1184935124
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Entity Type | Organization
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Legal Business Name | HEBBRONVILLE DENTAL GROUP
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Dates
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Enumeration Date | 06/24/2010
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Last Update Date | 06/24/2010
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Provider Practice Location Address
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Address Line | 312 E GALBRAITH ST
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City | HEBBRONVILLE
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State | TX
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Zip | 78361-3402
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Country | US
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Telephone | 361-527-4023
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Fax | 361-527-4213
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Provider Business Mailing Address
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Address Line | 312 E GALBRAITH ST
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City | HEBBRONVILLE
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State | TX
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Zip | 78361-3402
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Country | US
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Telephone | 361-527-4023
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Fax | 361-527-4213
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Authorized Official
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Title or Position | DENTIST
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Name | MR. RICARDO RAMIREZ
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Credential | DDS, FAGD
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Telephone | 361-527-4023
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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 | 23439
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License Number State | TX
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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 | 14118
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License Number State | TX
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