Individual
DR. ALEX A DEPERALTA JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2200 BERGQUIST DR, SUITE 1, LACKLAND A F B, TX 78236-9907
(210) 292-7876
(210) 292-7879
Mailing address
11 MAYBOROUGH LN, SAN ANTONIO, TX 78257-1242
(210) 698-6162
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
17410
TX
1223G0001X
General Practice Dentistry
28853
CA
Other
Enumeration date
01/12/2006
Last updated
07/08/2007
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