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Organization
TEXAS DENTAL ORTHODONTICS PRACTICE, PLLC
Active
Organization
TEXAS DENTAL ORTHODONTICS PRACTICE, PLLC
Active
Parent organization
TEXAS DENTAL ORTHODONTICS PRACTICE, PLLC
Other names
San Antonio Orthodontic Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
TEXAS DENTAL ORTHODONTICS PRACTICE, PLLC
Authorized official
GREGORY KOSTELAC (DATA ANALYST)
(719) 372-5605
Entity
Organization
Contact information
Practice address
20540 STATE HIGHWAY 46 W STE 100, SPRING BRANCH, TX 78070-6825
(830) 980-8099
Mailing address
6110 BARNES RD, COLORADO SPRINGS, CO 80922-2600
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
07/07/2022
Last updated
07/07/2022
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