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General NPI Number Information
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NPI Number | 1457763005
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Entity Type | Organization
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Legal Business Name | MC DENTAL CARE PLLC
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Dates
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Enumeration Date | 05/29/2014
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Last Update Date | 05/29/2014
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Provider Practice Location Address
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Address Line | 4500 N 10TH ST SUITE 20
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City | MCALLEN
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State | TX
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Zip | 78504-2928
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Country | US
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Telephone | 956-800-2219
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Fax |
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Provider Business Mailing Address
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Address Line | 2821 PELICAN AVE
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City | MCALLEN
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State | TX
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Zip | 78504-4275
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Country | US
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Telephone | 956-800-2219
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARITZA CHAVEZ
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Credential | DDS
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Telephone | 956-800-2219
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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 | 28908
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License Number State | TX
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