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Organization
LAITH FAMILY DENTRISTRY
Active
Organization
LAITH FAMILY DENTRISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RACHA W KHIREIWISH DDS (GENERAL DENTIST/OWNER)
(210) 782-6842
Entity
Organization
Contact information
Practice address
10865 SHAENFIELD RD, SUITE 1108, SAN ANTONIO, TX 78254-9601
(210) 782-6842
(210) 310-3475
Mailing address
10865 SHAENFIELD RD, SUITE 1108, SAN ANTONIO, TX 78254-9601
(210) 782-6842
(210) 310-3475
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
25079
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
TX
Enumeration date
01/12/2012
Last updated
01/12/2012
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