Organization
BOERNE ORTHODONTICS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES VANDEBERG D.D.S (OWNER)
(830) 331-8008
Entity
Organization
Contact information
Practice address
215 W BANDERA RD, SUITE # 112, BOERNE, TX 78006-2820
(830) 331-8008
Mailing address
215 WEST BANDERA ROAD, SUITE # 112, BOERNE, TX 78006
(210) 902-9122
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
23213
TX
Other
Enumeration date
07/09/2014
Last updated
07/10/2014
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