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Organization
MALDDS
Active
Organization
MALDDS
Active
Other names
ELITE DENTAL
Organization subpart
No
Provider details
NPI number
Authorized official
SANDY PARASH (PRACTICE MANAGER)
(210) 342-8251
Entity
Organization
Contact information
Practice address
4877 FREDERICKSBURG RD, SAN ANTONIO, TX 78229-3627
(210) 342-8251
(210) 342-8257
Mailing address
4877 FREDERICKSBURG RD, SAN ANTONIO, TX 78229-3627
(210) 342-8251
(210) 342-8257
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11248
TX
Other
Enumeration date
08/10/2011
Last updated
09/12/2012
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