# FLORESVILLE DENTAL PLLC

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

## Provider details

- **NPI number:** 1669884029
- **Authorized official:** DHAVAL THAKKAR (OWNER/DENTIST)
- **Authorized official phone:** (617) 771-2784

## Contact information

- **Practice address:** 540 10TH ST, FLORESVILLE, TX 78114-3154
- **Practice address phone:** (617) 771-2784
- **Mailing address:** 540 10TH ST, FLORESVILLE, TX 78114-3154

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 26483 | TX | Yes |

## Other

- **Enumeration date:** 05/20/2014
- **Last updated:** 05/20/2014