Organization
FULL SMILE DENTAL BRUSH COUNTRY ORTHODONTICS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM GRAVES DMD (OWNER)
(210) 543-8000
Entity
Organization
Contact information
Practice address
800 N BRYANT ST, PLEASANTON, TX 78064-2550
(210) 610-0117
Mailing address
11330 POTRANCO RD, SAN ANTONIO, TX 78253-7281
(806) 353-1055
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
12/19/2022
Last updated
04/18/2023
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