# DR MICHAEL J BRISENO DDS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568610061
- **Authorized official:** DR. MICHAEL JAVIER BRISENO (DENTIST)
- **Authorized official phone:** (210) 656-6362

## Contact information

- **Practice address:** 12215 TOEPPERWEIN RD, STE 100, SAN ANTONIO, TX 78233
- **Practice address phone:** (210) 656-6362
- **Practice address fax:** (210) 656-1538
- **Mailing address:** 12215 TOEPPERWEIN RD, STE 100, SAN ANTONIO, TX 78233
- **Mailing address phone:** (210) 656-6362
- **Mailing address fax:** (210) 656-1538

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 14469 | TX | Yes |

## Other

- **Enumeration date:** 09/09/2008
- **Last updated:** 09/09/2008