# AUTUMN HEIGHTS DENTAL PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114644226
- **Authorized official:** ESHA SHAH DDS (OWNER)
- **Authorized official phone:** (213) 440-2132

## Contact information

- **Practice address:** 7215 N. LOOP 1604 E., UNIT 102, CONVERSE, TX 78109
- **Practice address phone:** (210) 890-4909
- **Practice address fax:** (210) 890-4809
- **Mailing address:** 1311 MULESHOE PASS, SAN ANTONIO, TX 78258-3443
- **Mailing address phone:** (210) 890-4909
- **Mailing address fax:** (210) 890-4809

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/20/2022
- **Last updated:** 04/22/2023