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General NPI Number Information
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NPI Number | 1699381400
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Entity Type | Organization
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Legal Business Name | HOLA DENTAL S DE RL DE CV
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Dates
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Enumeration Date | 09/17/2020
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Last Update Date | 09/17/2020
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Provider Practice Location Address
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Address Line | C. ZARAGOZA 603 LOCAL B
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City | PIEDRAS NEGRAS
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State | COAHUILA
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Zip | 26000
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Country | MX
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Telephone | 830-421-3320
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Fax |
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Provider Business Mailing Address
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Address Line | 2016 E GARRISON ST STE 2-150
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City | EAGLE PASS
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State | TX
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Zip | 78852-5068
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Country | US
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Telephone | 830-421-3320
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MR. RAUL VILLALOBOS
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Credential |
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Telephone | 202-413-5391
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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