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General NPI Number Information
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NPI Number | 1932521994
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Entity Type | Organization
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Legal Business Name | TOEPPERRICAN OROFACIAL PLLC
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Dates
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Enumeration Date | 01/10/2014
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Last Update Date | 01/10/2014
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Provider Practice Location Address
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Address Line | 11515 TOEPPERWEIN RD SUITE 100
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City | LIVE OAK
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State | TX
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Zip | 78233-3151
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Country | US
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Telephone | 210-202-0406
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Fax | 210-978-5505
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Provider Business Mailing Address
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Address Line | 11515 TOEPPERWEIN RD SUITE 100
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City | LIVE OAK
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State | TX
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Zip | 78233-3151
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Country | US
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Telephone | 210-202-0406
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Fax |
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Authorized Official
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Title or Position | MEMBER CO-PRINCIPAL
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Name | DR. DAVID V MALAVE
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Credential | D.M.D.
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Telephone | 210-202-0406
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State | TX
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