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Organization
TX SOUTHERN DENTAL PPO PC
Active
Organization
TX SOUTHERN DENTAL PPO PC
Active
Parent organization
TX SOUTHERN DENTAL PPO PC
Other names
Ingram Hills Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
TX SOUTHERN DENTAL PPO PC
Authorized official
ERIKA MELISSA MENJIVAR (SR. CREDENTIALING SPECIALIST)
(469) 596-6137
Entity
Organization
Contact information
Practice address
4496 CALLAGHAN RD, SAN ANTONIO, TX 78228-3400
(210) 435-4601
Mailing address
5830 GRANITE PKWY STE 780, PLANO, TX 75024-6775
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
08/26/2026
Last updated
08/26/2026
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