Individual
ENAS BSOUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
5515 TEZEL RD STE 106, SAN ANTONIO, TX 78250-4143
(210) 682-2700
(210) 682-2701
Mailing address
8111 MAINLAND DR, SUITE 102, SAN ANTONIO, TX 78240-3748
(210) 682-2700
(210) 682-2701
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
31048
TX
1223G0001X
General Practice Dentistry
Primary
31048
TX
Other
Enumeration date
06/22/2015
Last updated
09/08/2015
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