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Organization

KIDS SMILE, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MAURICIO MARCUSHAMER DDS (OWNER)
(210) 225-8888
Entity
Organization

Contact information

Practice address
315 N SAN SABA, SUITE #1220, SAN ANTONIO, TX 78207-3154
(210) 225-8888
(210) 225-4195
Mailing address
315 N SAN SABA, SUITE#1220, SAN ANTONIO, TX 78207-3154
(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
1209389-02
TX
Enumeration date
06/20/2008
Last updated
06/20/2008
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