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General NPI Number Information
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NPI Number | 1417231382
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Entity Type | Organization
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Legal Business Name | MCPHERSON DENTAL CENTER
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Dates
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Enumeration Date | 10/10/2011
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Last Update Date | 10/10/2011
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Provider Practice Location Address
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Address Line | 6547 STAR CT #1
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City | LAREDO
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State | TX
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Zip | 78041
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Country | US
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Telephone | 956-717-8899
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Fax | 956-717-8898
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Provider Business Mailing Address
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Address Line | 6547 STAR CT #1
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City | LAREDO
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State | TX
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Zip | 78041
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Country | US
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Telephone | 956-717-8899
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Fax | 956-717-8898
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. MARIA M GUERRA-ZUNIGA
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Credential | D.D.S.
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Telephone | 956-717-8899
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 17103
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 16711
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License Number State | TX
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