Individual
DR. CARLOS ALONSO BERNAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
327 NW LOOP 410 STE 101, SAN ANTONIO, TX 78216-5304
(844) 776-4802
Mailing address
410 E EVERGREEN ST APT A, SAN ANTONIO, TX 78212-4422
(817) 996-9142
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
34486
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34486
TSBDE
TX
Enumeration date
08/30/2018
Last updated
08/30/2018
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