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General NPI Number Information
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NPI Number | 1417486333
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Entity Type | Organization
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Legal Business Name | CALALLEN DENTAL & ORTHODONTICS PLLC
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Dates
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Enumeration Date | 06/05/2017
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Last Update Date | 09/16/2022
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Provider Practice Location Address
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Address Line | 14101 NORTHWEST BLVD STE 111
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City | CORPUS CHRISTI
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State | TX
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Zip | 78410
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Country | US
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Telephone | 361-450-6700
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Fax | 361-450-6664
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Provider Business Mailing Address
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Address Line | 3838 N SAM HOUSTON PKWY E STE 430
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City | HOUSTON
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State | TX
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Zip | 77032-3418
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Country | US
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Telephone | 832-369-6941
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. GEETIKA RASTOGI
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Credential |
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Telephone | 832-369-6941
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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 | 25968
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License Number State | TX
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