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Organization

ELEGANZ DENTISTRY, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. QUINCY ATTIPOE DDS (DIRECTOR)
(469) 231-4419
Entity
Organization

Contact information

Practice address
1618 N VETERANS BLVD, SUITE A, SAN JUAN, TX 78589-3216
(469) 231-4419
Mailing address
1618 N VETERANS BLVD, SUITE A, SAN JUAN, TX 78589

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2
TX
Enumeration date
06/14/2016
Last updated
06/14/2016
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