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Organization
FULL SMILE DENTAL BOERNE ORTHODONTICS, PLLC
Active
Organization
FULL SMILE DENTAL BOERNE ORTHODONTICS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM GRAVES DMD (OWNER)
(806) 353-1055
Entity
Organization
Contact information
Practice address
215 W BANDERA RD STE 112, BOERNE, TX 78006-2842
(806) 353-1055
Mailing address
5051 S SONCY RD, AMARILLO, TX 79119-6667
(806) 353-1055
(806) 353-7077
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0221X
Pediatric Dentistry
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
12/09/2022
Last updated
12/09/2022
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