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Organization
TX SOUTHERN DENTAL PC
Active
Organization
TX SOUTHERN DENTAL PC
Active
Parent organization
TX SOUTHERN DENTAL PC
Other names
C. Roger Macias, Jr., DDS
Organization subpart
Yes
Provider details
NPI number
Legal business name
TX SOUTHERN DENTAL PC
Authorized official
CHRISTINE NELSON (VP, REVENUE CYCLE)
(469) 450-6482
Entity
Organization
Contact information
Practice address
21 SPURS LN STE 130, SAN ANTONIO, TX 78240-1670
(210) 614-2020
Mailing address
5830 GRANITE PKWY STE 780, PLANO, TX 75024-6775
(469) 450-6482
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
07/03/2023
Last updated
07/03/2023
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