Organization
ORTHODONTIC SPECIALISTS OF SEGUIN, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLARK D COLVILLE D.D.S., M.S. (OWNER PRESIDENT)
(830) 372-9811
Entity
Organization
Contact information
Practice address
205 S STATE HIGHWAY 46, SEGUIN, TX 78155-7504
(830) 372-9811
(830) 303-0149
Mailing address
205 S STATE HIGHWAY 46, SEGUIN, TX 78155-7504
(830) 372-9811
(830) 303-0149
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
15902
TX
Other
Enumeration date
01/08/2007
Last updated
08/22/2020
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