Organization
LIGHT DENTAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOINA MIHAELA CHARAN DDS (PRESIDENT)
(210) 673-8843
Entity
Organization
Contact information
Practice address
7323 MARBACH RD STE 101, SAN ANTONIO, TX 78227-1905
(210) 673-8843
Mailing address
7323 MARBACH RD STE 101, SAN ANTONIO, TX 78227-1905
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
26040
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1407976962
NPI
—
Enumeration date
06/28/2017
Last updated
06/28/2017
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