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General NPI Number Information
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NPI Number | 1417555780
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Entity Type | Organization
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Legal Business Name | TPC DENTAL CARE PC
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Dates
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Enumeration Date | 10/09/2020
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Last Update Date | 10/19/2020
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Provider Practice Location Address
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Address Line | 2610 TPC PKWY STE 102
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City | SAN ANTONIO
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State | TX
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Zip | 78259-2394
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Country | US
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Telephone | 210-497-4847
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Fax | 210-497-4983
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Provider Business Mailing Address
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Address Line | 2610 TPC PKWY STE 102
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City | SAN ANTONIO
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State | TX
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Zip | 78259-2394
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Country | US
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Telephone | 210-497-4847
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Fax | 210-497-4983
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. LUZ PASCAL
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Credential |
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Telephone | 210-497-4847
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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