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General NPI Number Information
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NPI Number | 1184991184
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Entity Type | Organization
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Legal Business Name | SAN ANTONIO DENTAL CENTER
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Dates
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Enumeration Date | 11/19/2011
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Last Update Date | 11/19/2011
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Provider Practice Location Address
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Address Line | 8610 NAPA LNDG
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City | BOERNE
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State | TX
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Zip | 78015
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Country | US
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Telephone | 210-788-9044
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Fax |
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Provider Business Mailing Address
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Address Line | 8610 NAPA LNDG
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City | BOERNE
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State | TX
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Zip | 78015-4853
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. FRANK ARYAN
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Credential |
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Telephone | 210-788-9044
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 24192
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License Number State | TX
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