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General NPI Number Information
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NPI Number | 1558695569
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Entity Type | Individual
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Provider Name | GISELLE CARDENAS EITTER DDS, MSD
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Gender | Female
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Dates
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Enumeration Date | 09/23/2009
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Last Update Date | 06/28/2012
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Provider Practice Location Address
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Address Line | 335 E SONTERRA BLVD STE 100 100
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City | SAN ANTONIO
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State | TX
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Zip | 78258-4071
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Country | US
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Telephone | 907-947-0240
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Fax |
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Provider Business Mailing Address
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Address Line | 335 E SONTERRA BLVD STE 100 100
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City | SAN ANTONIO
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State | TX
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Zip | 78258-4071
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Country | US
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Telephone | 907-947-0240
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | DE 00010840
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 27705
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License Number State | TX
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