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General NPI Number Information
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NPI Number | 1366809428
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Entity Type | Organization
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Legal Business Name | STEFAN IONESCU DDS PLLC
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Dates
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Enumeration Date | 01/20/2016
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Last Update Date | 01/20/2016
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Provider Practice Location Address
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Address Line | 415 S SCHOOL ST
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City | BOERNE
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State | TX
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Zip | 78006-2519
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Country | US
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Telephone | 830-249-9888
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Fax | 830-249-7919
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Provider Business Mailing Address
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Address Line | 415 S SCHOOL ST
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City | BOERNE
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State | TX
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Zip | 78006-2519
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Country | US
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Telephone | 830-249-9888
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Fax | 830-249-7919
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. STEFAN C IONESCU
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Credential | DDS
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Telephone | 830-249-9888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 25394
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License Number State | TX
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