Organization
VANDEBERG ORTHODONTICS, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES VANDEBERG D.D.S. M.S. (OWNER)
(210) 543-8000
Entity
Organization
Contact information
Practice address
9822 POTRANCO RD STE 105, SAN ANTONIO, TX 78251-9608
(210) 543-8000
(210) 543-8002
Mailing address
9822 POTRANCO RD STE 105, SAN ANTONIO, TX 78251-9608
(210) 543-8000
(210) 543-8002
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
23213
TX
Other
Enumeration date
12/02/2007
Last updated
12/02/2007
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