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General NPI Number Information
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NPI Number | 1275401663
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Entity Type | Organization
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Legal Business Name | FREDERICKSBURG FAMILY DENTAL CARE, PLLC
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Dates
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Enumeration Date | 10/27/2025
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 1703 FREDERICKSBURG ROAD, SUITE 101
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City | SAN ANTONIO
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State | TX
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Zip | 78201
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Country | US
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Telephone | 210-898-8113
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Fax |
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Provider Business Mailing Address
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Address Line | 5800 N INTERSTATE 35 STE 205
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City | DENTON
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State | TX
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Zip | 76207-1438
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Country | US
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Telephone | 940-220-7833
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Fax |
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Authorized Official
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Title or Position | DMD/OWNER
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Name | CRAIG COPELAND
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Credential | DMD
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Telephone | 940-220-7833
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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 |
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License Number State |
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