MEDICARE: SARKIS FAMILY DENTAL, P.A.

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	1223G0001X	General Practice Dentistry	23318	TX

General Provider Information

NPI Number	:	1174834253
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SARKIS FAMILY DENTAL, P.A.

Provider Business Mailing Address
First Line	:	1711 ESCADA
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-4531
Country	:	US
Telephone Number	:	210-577-8363
Fax Number	:

Provider Business Practice Location Address
First Line	:	3293 WURZBACH RD
Second Line	:	SUITE 103
City	:	SAN ANTONIO
State	:	TX
Zip	:	78238-4002
Country	:	US
Telephone Number	:	210-699-1122
Fax Number	:

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. ANTOINE W SARKIS
Credential	:	DDS
Telephone Number	:	210-577-8363

Provider Enumeration Date	:	06/23/2010
Last Update Date	:	02/09/2011

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