# BOERNE ORTHODONTICS, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1932515020
- **Authorized official:** DR. JAMES VANDEBERG D.D.S (OWNER)
- **Authorized official phone:** (830) 331-8008

## Contact information

- **Practice address:** 215 W BANDERA RD, SUITE \# 112, BOERNE, TX 78006-2820
- **Practice address phone:** (830) 331-8008
- **Mailing address:** 215 WEST BANDERA ROAD, SUITE \# 112, BOERNE, TX 78006
- **Mailing address phone:** (210) 902-9122

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 23213 | TX | Yes |

## Other

- **Enumeration date:** 07/09/2014
- **Last updated:** 07/10/2014