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General NPI Number Information
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NPI Number | 1871080374
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Entity Type | Organization
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Legal Business Name | MC DENTAL CARE OF EDINBURG 2, PLLC
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Dates
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Enumeration Date | 04/19/2018
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Last Update Date | 02/04/2021
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Provider Practice Location Address
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Address Line | 2939 REGENCY DR
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City | EDINBURG
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State | TX
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Zip | 78539-2216
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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 | 2821 PELICAN AVE
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City | MCALLEN
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State | TX
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Zip | 78504-4275
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Country | US
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Telephone | 956-800-2219
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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 | DR. MARITZA CHAVEZ
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Credential | DDS
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Telephone | 956-348-4411
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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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