Organization
HILDEBRAND FAMILY DENTAL CARE P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHIVA IZADDOUST D.D.S. (PRESIDENT)
(210) 733-9477
Entity
Organization
Contact information
Practice address
1001 W HILDEBRAND AVE, SAN ANTONIO, TX 78201-4609
(210) 733-9477
(210) 733-9561
Mailing address
1001 W HILDEBRAND AVE, SAN ANTONIO, TX 78201-4609
(210) 733-9477
(210) 733-9561
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G60126-01
TEXAS CHIP
TX
Enumeration date
03/16/2007
Last updated
08/22/2020
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