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Organization
LANESE FAMILY DENTAL,PA
Active
Organization
LANESE FAMILY DENTAL,PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLAUDETTE MORALES (OFFICE MGR)
(210) 684-5040
Entity
Organization
Contact information
Practice address
6502 BANDERA RD, STE 201, SAN ANTONIO, TX 78238-1400
(210) 684-5040
(210) 682-7785
Mailing address
6502 BANDERA RD, STE 201, SAN ANTONIO, TX 78238-1400
(210) 684-5040
(210) 682-7785
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
18063
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11189001
—
TX
Enumeration date
12/22/2011
Last updated
12/22/2011
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