Organization
LAITH FAMILY DENTISTRY CENTRAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RACHA KADAMANI (DDS/OWNER)
(210) 782-0008
Entity
Organization
Contact information
Practice address
3131 NACOGDOCHES RD STE 103, SAN ANTONIO, TX 78217-3335
(210) 782-0008
Mailing address
PO BOX 1735, HELOTES, TX 78023-1735
(210) 782-0008
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
25079
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1548495039
—
TX
Enumeration date
07/31/2017
Last updated
07/31/2017
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