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General NPI Number Information
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NPI Number | 1962202135
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Entity Type | Organization
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Legal Business Name | ARUKAH PEDIATRIC DENTISTRY PA
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Dates
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Enumeration Date | 03/17/2025
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 4553 N LOOP 1604 W STE 1211
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City | SAN ANTONIO
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State | TX
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Zip | 78249-1365
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Country | US
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Telephone | 210-306-4271
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Fax |
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Provider Business Mailing Address
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Address Line | 4553 N LOOP 1604 W STE 1211
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City | SAN ANTONIO
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State | TX
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Zip | 78249-1365
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Country | US
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Telephone | 210-306-4271
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | OMOLOLA A ADETONA
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Credential | DDS
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Telephone | 210-885-0035
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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 |
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License Number State |
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