Individual
DR. MITCHELL W PONSFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
248 N MAIN ST STE 1, BOERNE, TX 78006
(830) 816-5102
Mailing address
248 N MAIN ST STE 1, BOERNE, TX 78006-2036
(830) 816-5102
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
31434
TX
Other
Enumeration date
09/17/2015
Last updated
07/19/2018
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