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NPI Code Detail

MEDICARE: OAKWELL DENTAL CARE

MEDICARE: OAKWELL DENTAL CARE
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
11223G0001XGeneral Practice Dentistry27153TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11164574786OTHERTXNPI- OAKWELL DENTAL OLD
21104978725OTHERTXNPI- SUSAN RAQUET
31841324266OTHERTXNPI- DAVID SINGLETON
41710039334OTHERTXNPI- GREG OSBORNE
51871881730OTHERTXNPI- DYLAN CAREY

General Provider Information

NPI Number : 1972991735
Entity Type Code : Organization
Provider Name (Legal Business Name) : OAKWELL DENTAL CARE
Provider Business Mailing Address
First Line : 3301 OAKWELL CT ST 102
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78218
Country : US
Telephone Number : 210-832-9993
Fax Number :
Provider Business Practice Location Address
First Line : 3301 OAKWELL CT ST 102
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78218-3074
Country : US
Telephone Number : 210-832-9993
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. JOHN DYLAN CAREY
Credential : DDS
Telephone Number : 210-832-9993
Provider Enumeration Date : 01/02/2015
Last Update Date : 01/02/2015

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Directions to “OAKWELL DENTAL CARE ” Practice Location

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