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NPI Code Detail

MEDICARE: VICENTE CANALES DDS

MEDICARE: VICENTE CANALES DDS
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
1122300000XDentist0022016TX

General Provider Information

NPI Number : 1255432548
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICENTE CANALES DDS
Provider Business Mailing Address
First Line : 3750 COMMERCIAL AVE
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78221-3117
Country : US
Telephone Number : 210-922-7000
Fax Number : 210-923-4167
Provider Business Practice Location Address
First Line : 3750 COMMERCIAL AVE
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78221-3117
Country : US
Telephone Number : 210-922-7000
Fax Number : 210-923-4167
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2006
Last Update Date : 02/05/2019

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Directions to “ VICENTE CANALES DDS” Practice Location

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