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Organization
WESTLAKES FAMILY DENTAL, PA
Active
Organization
WESTLAKES FAMILY DENTAL, PA
Active
Other names
Westlakes Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KERRY W NELSON DDS (OWNER/PRESIDENT)
(210) 675-9200
Entity
Organization
Contact information
Practice address
9522 POTRANCO RD, SAN ANTONIO, TX 78251-9601
(210) 675-9200
(210) 521-9204
Mailing address
9522 POTRANCO RD, SAN ANTONIO, TX 78251-9601
(210) 675-9200
(210) 521-9204
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
20528
TX
261QD0000X
Dental Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1801818364
INDIVIDUAL NPI
TX
Enumeration date
03/29/2012
Last updated
08/06/2020
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