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Organization
SACS PROFESSIONALS
Active
Organization
SACS PROFESSIONALS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KETAN SUKKAWALA DDS (OWNER)
(979) 450-1116
Entity
Organization
Contact information
Practice address
8706 FREDERICKSBURG RD STE 104, SAN ANTONIO, TX 78240-1200
(713) 481-9500
Mailing address
8706 FREDERICKSBURG RD STE 104, SAN ANTONIO, TX 78240-1200
(713) 481-9500
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
26232
TX
Other
Enumeration date
12/11/2013
Last updated
04/03/2024
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