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Organization
TEXAS DENTAL SPECIALIST PRACTICE, PLLC
Active
Organization
TEXAS DENTAL SPECIALIST PRACTICE, PLLC
Active
Parent organization
TEXAS DENTAL SPECIALIST PRACTICE, PLLC
Other names
Texas Dental Specialists
Organization subpart
Yes
Provider details
NPI number
Legal business name
TEXAS DENTAL SPECIALIST PRACTICE, PLLC
Authorized official
GREGORY KOSTELAC (CREDENTIALING SPECIALIST)
(719) 372-5605
Entity
Organization
Contact information
Practice address
1583 E COMMON ST STE 205, NEW BRAUNFELS, TX 78130-3174
(830) 625-2111
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
12/20/2021
Last updated
07/26/2022
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