Organization
SAN MARCOS DENTAL AND BRACES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSA WOLFFORD (CREDENTIALING SPECIALIST)
(210) 568-9800
Entity
Organization
Contact information
Practice address
102 WONDER WORLD DR STE 101, SAN MARCOS, TX 78666-6080
(210) 944-0504
Mailing address
PO BOX 849, JASPER, TX 75951-0010
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
11/06/2023
Last updated
11/13/2023
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