Individual
DR. ROQUE MARISCAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
315 N SAN SABA, SUITE 925, SAN ANTONIO, TX 78207-3154
(210) 227-1991
Mailing address
315 N SAN SABA, SUITE 925, SAN ANTONIO, TX 78207-3154
(210) 227-1991
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
15348
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1209736-02
—
TX
Enumeration date
05/08/2008
Last updated
05/08/2008
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