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General NPI Number Information
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NPI Number | 1306353628
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Entity Type | Organization
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Legal Business Name | CRYSTAL DENTAL CARE PLLC
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Dates
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Enumeration Date | 01/08/2018
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Last Update Date | 01/08/2018
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Provider Practice Location Address
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Address Line | 402 E ZAVALA ST STE 1
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City | CRYSTAL CITY
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State | TX
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Zip | 78839-3337
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Country | US
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Telephone | 830-326-2740
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Fax |
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Provider Business Mailing Address
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Address Line | 5565 MANSIONS BLFS APT 4301
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City | SAN ANTONIO
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State | TX
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Zip | 78245-0019
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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 | OWNER
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Name | DR. VIVEK SINGH
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Credential | DDS
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Telephone | 830-326-2740
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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 | 31916
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License Number State | TX
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