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General NPI Number Information
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NPI Number | 1831602796
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Entity Type | Individual
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Provider Name | GWENDOLYN TAYLOR CALDERON DDS
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Gender | Female
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Dates
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Enumeration Date | 11/13/2017
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Last Update Date | 10/21/2024
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Provider Practice Location Address
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Address Line | 4158 SWANS LNDG
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City | SAN ANTONIO
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State | TX
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Zip | 78217-4239
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Country | US
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Telephone | 210-655-4867
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Fax |
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Provider Business Mailing Address
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Address Line | 327 OAK GLEN DR
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City | SAN ANTONIO
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State | TX
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Zip | 78209-2428
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Country | US
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Telephone | 210-459-9907
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 33106
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License Number State | TX
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