Ingram Mall Dental Center, P.l.l.c.
NPI #1043541741 in San Antonio, Texas
Provider Information
- NPI Number
- 1043541741
- Entity Type
- Organization
- Organization Name
- Ingram Mall Dental Center, P.l.l.c.
- Primary Specialty
- Dentist
- Enumeration Date
- Jan 19, 2010
- Last Updated
- Jan 19, 2010
Practice Location
- Address
- 6301 NW LOOP 410
- Address 2
- L1A
- City
- San Antonio
- State
- Texas
- ZIP Code
- 78238-3824
- Phone
- (210) 354-4867
Authorized Official
- Name
- MS. BERTHA ELIZABETH RODRIGUEZ
- Title
- REGIONAL MANAGER
- Phone
- (210) 354-4867
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist |
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