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Organization
MODERN DENTAL PROFESSIONALS SAN ANTONIO PC
Active
Organization
MODERN DENTAL PROFESSIONALS SAN ANTONIO PC
Active
Other names
Castle Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARCUS ERVIN DDS (OWNER)
(210) 653-4867
Entity
Organization
Contact information
Practice address
17700 SAN PEDRO AVE, SUITE 320, SAN ANTONIO, TX 78232-1404
(210) 495-6255
(210) 495-6260
Mailing address
8415 DATAPOINT DR, SUITE 1020, SAN ANTONIO, TX 78229-3298
(714) 578-6358
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
20569
TX
Other
Enumeration date
11/09/2006
Last updated
12/07/2016
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