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Organization
DE ZAVALA MODERN DENTISTRY, PC
Active
Organization
DE ZAVALA MODERN DENTISTRY, PC
Active
Other names
De Zavala Modern Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERTO A. BENAVIDES DDS (OWNER)
(210) 740-0645
Entity
Organization
Contact information
Practice address
5215 DE ZAVALA RD STE 103, SAN ANTONIO, TX 78249-2985
(210) 740-0645
(210) 757-4067
Mailing address
PO BOX 920050, DALLAS, TX 75392-0050
(714) 845-8206
(303) 952-0892
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
09/11/2019
Last updated
02/11/2022
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