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General NPI Number Information
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NPI Number | 1972761450
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Entity Type | Organization
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Legal Business Name | RALPH A. CREVOISIER D.D.S.,M.S.D. PC
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Dates
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Enumeration Date | 05/30/2008
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Last Update Date | 05/30/2008
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Provider Practice Location Address
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Address Line | 8110 WINDWAY DR
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City | SAN ANTONIO
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State | TX
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Zip | 78239-2433
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Country | US
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Telephone | 210-653-9227
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Fax |
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Provider Business Mailing Address
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Address Line | 14107 COUNTRY VALE
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City | SAN ANTONIO
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State | TX
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Zip | 78216-2354
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Country | US
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Telephone | 210-494-4978
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RALPH AARON CREVOISIER
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Credential | D.D.S.,M.S.D.
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Telephone | 210-494-4978
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 7663
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License Number State | TX
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