Organization
FORTUNA A VARDEMAN DDS PC
Active
Parent organization
RANDOLPH FAMILY DENTAL
Other names
Randolph Family Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
RANDOLPH FAMILY DENTAL
Authorized official
DR. FORTUNA ALAPAG VARDEMAN DDS (OWNER)
(210) 658-9031
Entity
Organization
Contact information
Practice address
117 E LANGLEY, UNIVERSAL CITY, TX 78148-4414
(210) 658-9031
(210) 658-8202
Mailing address
117 E LANGLEY, UNIVERSAL CITY, TX 78148-4414
(210) 658-9031
(210) 658-8202
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
18827
TX
Other
Enumeration date
09/23/2010
Last updated
09/23/2010
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