Individual
MICHAEL TERRY GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1100 WILFORD HALL LOOP BLDG 4554, SAN ANTONIO, TX 78236-5638
(210) 916-6491
Mailing address
1100 WILFORD HALL LOOP BLDG 4554, SAN ANTONIO, TX 78236-5638
(210) 916-6491
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
4375
AL
Other
Enumeration date
08/19/2006
Last updated
03/08/2021
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