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General NPI Number Information
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NPI Number | 1679328454
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Entity Type | Organization
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Legal Business Name | LUXE DENTISTRY PLLC
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Dates
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Enumeration Date | 04/23/2024
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Last Update Date | 04/23/2024
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Provider Practice Location Address
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Address Line | 15900 LA CANTERA PKWY STE 4400
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City | SAN ANTONIO
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State | TX
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Zip | 78256-2587
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Country | US
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Telephone | 210-699-4600
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Fax |
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Provider Business Mailing Address
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Address Line | 2701 SAVOY PL
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City | MIDLAND
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State | TX
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Zip | 79705-2304
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | BRANDON REBBER
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Credential | DDS
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Telephone | 210-699-4600
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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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