Organization
EMPIRE DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SEEMA CHANDI (BUSSINESS MANAGER)
(443) 944-6969
Entity
Organization
Contact information
Practice address
1915 ROGERS ROAD, SAN ANTONIO, TX 78251-7825
(443) 944-6969
Mailing address
6307 GRANADA WAY, SAN ANTONIO, TX 78257-1733
(443) 944-6969
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29662
TEXAS LICENSE
TX
Enumeration date
01/25/2019
Last updated
01/25/2019
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