Individual
DIEGO IGNACIO FERNANDEZ VIAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS MS
Contact information
Practice address
12626 WOODFOREST BLVD STE Z, HOUSTON, TX 77015-3653
(171) 359-0099
Mailing address
1916 W GRAY ST APT 240, HOUSTON, TX 77019-4834
(859) 382-3910
Taxonomy
Speciality
Code
Description
License number
State
1223X2210X
Orofacial Pain Dentistry
Primary
39810
TX
Other
Enumeration date
07/11/2023
Last updated
08/02/2023
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