Organization
SOUTH TEXAS CHILDRENS DENTISTRY P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VICTOR IGUNBOLA D.D.S. (PRESIDENT)
(830) 278-5009
Entity
Organization
Contact information
Practice address
408 S GETTY ST, UVALDE, TX 78801-5609
(830) 278-5009
Mailing address
408 S GETTY ST, UVALDE, TX 78801-5609
(830) 278-5009
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
18691
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
144619701
—
TX
Enumeration date
03/16/2012
Last updated
03/16/2012
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