Organization
CROWNRIDGE DENTAL
Active
Organization
CROWNRIDGE DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTIAN ALEXANDER PHAM (OWNER)
(210) 538-7500
Entity
Organization
Contact information
Practice address
6827 CAMP BULLIS RD STE 302, SAN ANTONIO, TX 78256-1730
(210) 538-7500
(210) 569-7750
Mailing address
6827 CAMP BULLIS RD STE 302, SAN ANTONIO, TX 78256-1730
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
—
—
Other
Enumeration date
06/23/2020
Last updated
06/23/2020
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