Organization
SOH OF TEXAS SAMSON LIU PLLC
Active
Other names
Bunn Orthodontic Group
Organization subpart
No
Provider details
NPI number
Authorized official
DINKA JENNINGS (EMPLOYEE RELATIONS MANAGER)
(636) 362-4986
Entity
Organization
Contact information
Practice address
7230 BRIAR PL, SAN ANTONIO, TX 78221-1600
(210) 921-9191
Mailing address
1422 ELBRIDGE PAYNE RD STE 240, CHESTERFIELD, MO 63017-8544
(636) 362-4986
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
09/23/2020
Last updated
09/23/2020
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