# NORIEGA DENTAL GROUP PLLC

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

## Provider details

- **NPI number:** 1114742236
- **Authorized official:** CARLOS QUEZADA DDS (OWNER DENTIST)
- **Authorized official phone:** (956) 438-2073

## Contact information

- **Practice address:** 4315 MOONLIGHT WAY STE 101, SAN ANTONIO, TX 78230-1690
- **Practice address phone:** (210) 263-3838
- **Mailing address:** 4315 MOONLIGHT WAY STE 101, SAN ANTONIO, TX 78230-1690

## Taxonomy

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

## Other

- **Enumeration date:** 11/22/2024
- **Last updated:** 11/22/2024