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General NPI Number Information
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NPI Number | 1689177925
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Entity Type | Organization
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Legal Business Name | MC DENTAL CARE OF EDINBURG, PLLC
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Dates
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Enumeration Date | 03/13/2018
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Last Update Date | 02/04/2021
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Provider Practice Location Address
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Address Line | 8814 E HWY 107 STE B
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City | EDINBURG
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State | TX
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Zip | 78542-3760
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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 | 2413 E INTERSTATE HIGHWAY 2 STE 50
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City | MISSION
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State | TX
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Zip | 78572-1019
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Country | US
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Telephone | 956-583-5430
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Fax |
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Authorized Official
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Title or Position | DENTIST OWNER
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Name | MARTIZA CHAVEZ
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Credential | DDS
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Telephone | 956-583-2588
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 28908
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License Number State | TX
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