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Organization
NORTHWEST DENTAL MANAGEMENT, PA
Active
Organization
NORTHWEST DENTAL MANAGEMENT, PA
Active
Other names
Mary B. Mellard, DDS
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY B MELLARD DDS (PRESIDENT)
(210) 687-1133
Entity
Organization
Contact information
Practice address
24200 W IH 10, SUITE 112, SAN ANTONIO, TX 78257-1145
(210) 687-1133
(210) 687-1132
Mailing address
24200 W IH 10, SUITE 112, SAN ANTONIO, TX 78257-1145
(210) 687-1133
(210) 687-1132
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
13920
TX
Other
Enumeration date
07/28/2005
Last updated
03/26/2010
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