Organization
FIESTA DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TEJAL DHANANI (OWNER)
(682) 234-4603
Entity
Organization
Contact information
Practice address
166 MENEFEE ST, SUITE C, HONDO, TX 78861
(201) 920-6343
Mailing address
166 MENEFEE ST, SUITE C, HONDO, TX 78861
(617) 913-2151
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
25831
TX
Other
Enumeration date
08/21/2014
Last updated
08/12/2015
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