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Organization
SV DENTAL
Active
Organization
SV DENTAL
Active
Other names
Pearsall Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
TAPAN TIRUMALA TEJA VALLABHANENI DMD (OWNER)
(830) 334-3333
Entity
Organization
Contact information
Practice address
111 N ASH ST, PEARSALL, TX 78061-3201
(830) 334-3333
(830) 334-3337
Mailing address
111 N ASH ST, PEARSALL, TX 78061-3201
(830) 334-3333
(830) 334-3337
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1962922351
INDIVIDUAL NPI
TX
Enumeration date
07/10/2020
Last updated
07/13/2020
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