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General NPI Number Information
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NPI Number | 1235364696
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Entity Type | Organization
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Legal Business Name | MOONEY FAMILY & COSMETIC DENTISTRY, PLLC
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Dates
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Enumeration Date | 05/28/2009
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Last Update Date | 05/28/2009
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Provider Practice Location Address
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Address Line | 23535 W IH 10 SUITE 2202
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City | SAN ANTONIO
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State | TX
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Zip | 78257-1668
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Country | US
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Telephone | 210-687-1444
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Fax | 210-687-1445
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Provider Business Mailing Address
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Address Line | 23535 W IH 10 SUITE 2202
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City | SAN ANTONIO
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State | TX
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Zip | 78257-1668
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Country | US
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Telephone | 210-687-1444
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Fax | 210-687-1445
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Authorized Official
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Title or Position | OWNER
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Name | DR. RYAN P MOONEY
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Credential | DDS
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Telephone | 210-639-0737
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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 | 23344
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License Number State | TX
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