# MYSA DENTAL PLLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MYSA DENTAL PLLC
- **Other names:** Mysa Dental
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1710587431
- **Legal business name:** MYSA DENTAL PLLC
- **Authorized official:** DR. KHUSHBU MALHOTRA DMD (DENTIST)
- **Authorized official phone:** (617) 834-4646

## Contact information

- **Practice address:** 13762 POTRANCO RD STE 105, SAN ANTONIO, TX 78253-4047
- **Practice address phone:** (210) 564-9044
- **Practice address fax:** (210) 564-9088
- **Mailing address:** 10615 YSAMY WAY, SAN ANTONIO, TX 78213-1659
- **Mailing address phone:** (617) 834-4646

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/30/2020
- **Last updated:** 05/15/2023