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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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