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General NPI Number Information
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NPI Number | 1972760536
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Entity Type | Organization
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Legal Business Name | MCCABE & LANESE FAMILY DENTAL
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Dates
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Enumeration Date | 05/21/2008
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Last Update Date | 05/21/2008
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Provider Practice Location Address
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Address Line | 11223 POTRANCO RD SUITE 200
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City | SAN ANTONIO
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State | TX
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Zip | 78253
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Country | US
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Telephone | 210-679-7282
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Fax | 210-679-7270
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Provider Business Mailing Address
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Address Line | 11223 POTRANCO RD SUITE 200
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City | SAN ANTONIO
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State | TX
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Zip | 78253
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Country | US
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Telephone | 210-679-7282
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Fax | 210-679-7270
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Authorized Official
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Title or Position | FRONT OFFICE
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Name | RHONDA LANGEHENNIG
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Credential |
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Telephone | 210-679-7282
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 18063
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License Number State | TX
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