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Individual

GIANCARLO SANTOS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S

Contact information

Practice address
1500 S AW GRIMES BLVD STE 190, ROUND ROCK, TX 78664-7843
(512) 255-5900
Mailing address
1500 S. AW GRIMES BLVD, STE 190, ROUND ROCK, TX 78664
(412) 648-8419

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
31700
TX

Other

Enumeration date
10/27/2014
Last updated
08/03/2017
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