MEDICARE: FLOMO DENTAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1003507823
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLOMO DENTAL

Provider Business Mailing Address
First Line	:	7400 BLANCO RD STE 205
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78216-4361
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2704 CROSS TIMBERS RD STE 108
Second Line	:
City	:	FLOWER MOUND
State	:	TX
Zip	:	75028-2700
Country	:	US
Telephone Number	:	469-933-0073
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	KHUSHBU MALHOTRA
Credential	:
Telephone Number	:	617-834-4646

Provider Enumeration Date	:	05/15/2023
Last Update Date	:	09/18/2023

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Directions to “FLOMO DENTAL ” Practice Location

Language	Start Address	Practice Location

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