Organization
SOUTHSIDE CHILDREN'S DENTAL CENTER, P.C.
Active
Other names
Scott Hebert DDS
Organization subpart
No
Provider details
NPI number
Authorized official
DORIS CODERRE-ZERCHER (OFFICE MANAGER)
(210) 922-3483
Entity
Organization
Contact information
Practice address
125 SW MILITARY DR, SAN ANTONIO, TX 78221-1650
(210) 922-3483
(210) 922-8902
Mailing address
125 SW MILITARY DR, SAN ANTONIO, TX 78221-1650
(210) 922-3483
(210) 922-8902
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
Primary
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007874
DELTA CARE
TX
05
—
126722102
—
TX
01
—
38644
UNITED HEALTHCARE
TX
01
—
695123
UNITED CONCORDIA
TX
01
—
84D747
BLUECROSS
TX
Enumeration date
08/05/2006
Last updated
10/21/2022
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