Individual
DR. MARIA TIEFENBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
3435 S ALAMEDA ST STE A, CORPUS CHRISTI, TX 78411-1797
(361) 853-0381
(361) 992-1862
Mailing address
6200 SARATOGA BLVD, CORPUS CHRISTI, TX 78414-3421
(361) 992-9500
(361) 992-1862
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
21454
TX
1223P0221X
Pediatric Dentistry
Primary
21454
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
159673601
—
TX
Enumeration date
07/07/2006
Last updated
07/07/2010
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