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General NPI Number Information
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NPI Number | 1710430731
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Entity Type | Organization
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Legal Business Name | CATHERINE BOENITZ, DDS, PLLC
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Dates
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Enumeration Date | 07/26/2016
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Last Update Date | 07/26/2016
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Provider Practice Location Address
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Address Line | 8647 WURZBACH RD BLDG. A
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City | SAN ANTONIO
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State | TX
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Zip | 78240-1225
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Country | US
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Telephone | 210-690-9430
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Fax | 210-690-2919
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Provider Business Mailing Address
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Address Line | 8647 WURZBACH RD BLDG. A
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City | SAN ANTONIO
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State | TX
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Zip | 78240-1225
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Country | US
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Telephone | 210-690-9430
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Fax | 210-690-2919
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Authorized Official
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Title or Position | OWNER
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Name | DR. CATHERINE COX BOENITZ
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Credential | DDS
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Telephone | 512-431-9792
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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 | 27044
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License Number State | TX
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