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General NPI Number Information
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NPI Number | 1336226364
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Entity Type | Organization
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Legal Business Name | C M DISHMAN DDS INC
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 116 N FIFTH ST
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City | UVALDE
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State | TX
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Zip | 78801-5415
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Country | US
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Telephone | 830-278-2549
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Fax | 830-278-2848
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Provider Business Mailing Address
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Address Line | 116 N FIFTH ST
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City | UVALDE
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State | TX
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Zip | 78801-5415
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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 | CHARLES M DISHMAN
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Credential | DDS
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Telephone | 830-278-2549
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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 | 11997
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License Number State | TX
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