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Organization

NURSING HOME DENTISTRY, PLLC

Active
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Organization

NURSING HOME DENTISTRY, PLLC

Active
Other names
Nursing Home Dentistry
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MELODIE R DIAMOND DDS (MANAGING MEMBER)
(214) 218-7403
Entity
Organization

Contact information

Practice address
1615 11TH ST, FLORESVILLE, TX 78114-2403
(214) 218-7403
(210) 899-0077
Mailing address
14439 NW MILITARY HWY, SUITE 108, BOX 424, SAN ANTONIO, TX 78231
(210) 248-9946
(210) 899-0077

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
28498
TX

Other

Enumeration date
01/30/2017
Last updated
01/30/2017
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