Organization
NORTHEAST CHILDREN'S DENTISTRY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACEY HAY (PRACTICE COORDINATOR)
(210) 654-6882
Entity
Organization
Contact information
Practice address
8606 VILLAGE DR, STE. B, SAN ANTONIO, TX 78217-5506
(210) 654-6882
(210) 654-0036
Mailing address
8606 VILLAGE DR, STE. B, SAN ANTONIO, TX 78217-5506
(210) 654-6882
(210) 654-0036
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
11694
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00K78V
BLUE CROSS BLUE SHIELD
TX
Enumeration date
07/25/2006
Last updated
08/15/2019
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us