Organization
ELIZABETH MATTSSON DDS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH MATTSSON DDS (OWNER)
(210) 349-3715
Entity
Organization
Contact information
Practice address
1202 E SONTERRA BLVD STE 502, SAN ANTONIO, TX 78258-4092
(210) 349-3715
Mailing address
1202 E SONTERRA BLVD STE 502, SAN ANTONIO, TX 78258-4092
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
23987
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23987
DENTAL LICENSE
TX
Enumeration date
06/23/2016
Last updated
06/23/2016
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