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General NPI Number Information
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NPI Number | 1225369978
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Entity Type | Organization
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Legal Business Name | SUN ORTHODONTIX OF VICTORIA, PLLC
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Dates
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Enumeration Date | 01/20/2010
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Last Update Date | 04/03/2012
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Provider Practice Location Address
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Address Line | 7002 NE ZAC LENTZ PKWY SUITE B
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City | VICTORIA
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State | TX
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Zip | 77904-3450
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Country | US
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Telephone | 361-573-7464
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Fax | 361-573-0282
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Provider Business Mailing Address
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Address Line | 1620 S PADRE ISLAND DR
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City | CORPUS CHRISTI
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State | TX
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Zip | 78416-1353
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Country | US
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Telephone | 361-853-1900
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Fax |
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MRS. CHRISTEL DINKLER
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Credential |
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Telephone | 361-654-5616
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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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