Individual
BANGORN TERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1218 SW MILITARY DR, SAN ANTONIO, TX 78221-1535
(210) 927-1000
Mailing address
1218 SW MILITARY DR, SAN ANTONIO, TX 78221-1535
(210) 927-1000
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
20409
TX
Other
Enumeration date
12/11/2006
Last updated
07/08/2007
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