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General NPI Number Information
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NPI Number | 1437229762
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Entity Type | Organization
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Legal Business Name | CORNERSTONE COSMETIC & FAMILY DENTISTRY
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 08/08/2008
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Provider Practice Location Address
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Address Line | 2708 CORNERSTONE BLVD
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City | EDINBURG
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State | TX
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Zip | 78539
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Country | US
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Telephone | 956-686-5511
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Fax | 956-686-9955
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Provider Business Mailing Address
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Address Line | 2708 CORNERSTONE BLVD
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City | EDINBURG
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State | TX
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Zip | 78539
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Country | US
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Telephone | 956-686-5511
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Fax | 956-686-9955
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Authorized Official
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Title or Position | OWNER
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Name | VLADISLAV V LOSHKAREV
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Credential | DDS PHD
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Telephone | 956-686-5511
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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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