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Organization

DEERFIELD DENTAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. IRENE KIANSKY BLAESS (VICE PRESIDENT)
(210) 445-7915
Entity
Organization

Contact information

Practice address
14855 BLANCO RD STE 413, SAN ANTONIO, TX 78216-7731
(210) 408-6000
Mailing address
5999 DE ZAVALA RD STE 122, SAN ANTONIO, TX 78249-2236
(210) 408-6000
(210) 561-2599

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
19006
TX

Other

Enumeration date
09/16/2010
Last updated
09/16/2010
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