Individual
DR. MAURICIO MARCUSHAMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3006 BROADWAY STE 103, SAN ANTONIO, TX 78209-1561
(210) 225-8888
(210) 225-4195
Mailing address
3006 BROADWAY STE 103, SAN ANTONIO, TX 78209-1561
(210) 225-8888
(210) 225-4195
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
18580
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120938902
—
TX
Enumeration date
11/29/2006
Last updated
01/25/2024
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