Organization
ANDREW DE LA GARZA, JR., DDS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW DE LA GARZA JR. DDS (PRESIDENT)
(210) 227-1991
Entity
Organization
Contact information
Practice address
315 N SAN SABA, SUITE 925, SAN ANTONIO, TX 78207-3154
(210) 227-1991
Mailing address
315 N SAN SABA, SUITE 925, SAN ANTONIO, TX 78207-3154
(210) 227-1991
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11944
TX
1223G0001X
General Practice Dentistry
5943
TX
1223P0221X
Pediatric Dentistry
15348
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11944
DENTAL LICENSE
TX
05
—
1209736-02
—
TX
05
—
1332751-02
—
TX
01
—
15348
DENTAL LICENSE
TX
01
—
5943
DENTAL LICENSE
TX
01
—
G60035-1
TEXAS CHIP DELTA DENTAL SERVICES
TX
Enumeration date
05/14/2008
Last updated
05/14/2008
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