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Organization
PREMIER DENTAL SEGUIN
Active
Organization
PREMIER DENTAL SEGUIN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUIGI O MASSA (OWNER)
(830) 625-2111
Entity
Organization
Contact information
Practice address
104 W CEDAR ST, SEGUIN, TX 78155-3748
(830) 379-9310
(830) 401-0230
Mailing address
104 W CEDAR ST, SEGUIN, TX 78155-3748
(830) 379-9310
(830) 401-0230
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22462
TX
Other
Enumeration date
10/21/2009
Last updated
10/21/2009
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