Organization
NORTHEAST CHILDREN'S DENTISTRY, INC
Active
Parent organization
NORTHEAST CHILDREN'S DENTISTRY, INC
Other names
Northeast Children's Dentistry-Schertz Location
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTHEAST CHILDREN'S DENTISTRY, INC
Authorized official
TRACEY HAY (PRACTICE COORDINATOR)
(210) 654-6882
Entity
Organization
Contact information
Practice address
5000 SCHERTZ PKWY STE 301, SCHERTZ, TX 78154-1457
(210) 659-8000
(210) 659-9235
Mailing address
5000 SCHERTZ PKWY STE 301, SCHERTZ, TX 78154-1457
(210) 659-8000
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00K78
BLUE CROSS BLUE SHIELD
TX
Enumeration date
08/15/2019
Last updated
11/27/2023
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