Organization
DEZAVALA FAMILY DENTAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDIA NADIMI DMD (PRESIDENT)
(210) 696-7885
Entity
Organization
Contact information
Practice address
5563 DE ZAVALA RD, 160, SAN ANTONIO, TX 78249-1734
(210) 696-7885
Mailing address
5563 DE ZAVALA RD STE 160, SAN ANTONIO, TX 78249-1738
(210) 696-7885
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
26540
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
28162330
—
TX
Enumeration date
11/16/2016
Last updated
11/16/2016
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