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General NPI Number Information
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NPI Number | 1407917800
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Entity Type | Individual
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Provider Name | HENRY MARCANTONI D.D.S
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Gender | Male
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 09/01/2009
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Provider Practice Location Address
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Address Line | 10801 N MO PAC EXPY BLDG. 2 STE.130
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City | AUSTIN
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State | TX
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Zip | 78759-5459
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Country | US
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Telephone | 512-372-6230
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Fax | 512-372-6233
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Provider Business Mailing Address
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Address Line | 10801 N MO PAC EXPY BLDG. 2 STE.130
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City | AUSTIN
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State | TX
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Zip | 78759-5459
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Country | US
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Telephone | 512-372-6230
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Fax | 512-372-6233
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 18386
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License Number State | TX
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