Organization
RIVER CITY ORAL AND MAXILLOFACIAL SURGERY, PLLC
Active
Organization
RIVER CITY ORAL AND MAXILLOFACIAL SURGERY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK HAVERKORN DDS, MD (OWNER)
(210) 778-0002
Entity
Organization
Contact information
Practice address
5418 N LOOP 1604 E, SUITE 101, SAN ANTONIO, TX 78023
(210) 778-0002
Mailing address
PO BOX 1719, HELOTES, TX 78023-1719
(210) 778-0002
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
—
—
Other
Enumeration date
10/10/2018
Last updated
10/10/2018
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