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Organization
TOOTH DENTAL CENTER PA
Active
Organization
TOOTH DENTAL CENTER PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELMA MOYA-FONSECA (CO-SUPERVISOR)
(956) 627-2385
Entity
Organization
Contact information
Practice address
3609 N WARE RD, MCALLEN, TX 78501-3304
(956) 627-2385
(956) 627-2473
Mailing address
3609 N WARE RD, MCALLEN, TX 78501-3304
(956) 627-2385
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1720681471
NPI
TX
Enumeration date
11/17/2020
Last updated
11/22/2022
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