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General NPI Number Information
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NPI Number | 1376774851
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Entity Type | Individual
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Provider Name | HARMANDEEP SINGH WADHWA DDS
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Gender | Male
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Dates
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Enumeration Date | 08/02/2009
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Last Update Date | 01/27/2017
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Provider Practice Location Address
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Address Line | 2828 GOLIAD RD STE 120
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City | SAN ANTONIO
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State | TX
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Zip | 78223-3960
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Country | US
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Telephone | 210-468-1743
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Fax |
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Provider Business Mailing Address
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Address Line | 8943 CIMARRON RTE
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City | SAN ANTONIO
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State | TX
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Zip | 78255-2382
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Country | US
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Telephone | 210-858-6001
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 24863
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License Number State | TX
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