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Organization
WESTOVER HILLS FAMILY DENTAL CARE, LP
Active
Organization
WESTOVER HILLS FAMILY DENTAL CARE, LP
Active
Other names
WH FAMILY DENTAL CARE, LP
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHIVA IZADDOUST D.D.S. (PRESIDENT)
(210) 927-1400
Entity
Organization
Contact information
Practice address
11212 STATE HIGHWAY 151, STE # 209, SAN ANTONIO, TX 78251-4498
(210) 927-1400
(210) 927-6330
Mailing address
11212 STATE HIGHWAY 151, STE # 209, SAN ANTONIO, TX 78251-4498
(210) 927-1400
(210) 927-6330
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
17028
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1363434-11
—
TX
Enumeration date
04/14/2014
Last updated
04/14/2014
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