My Local Texas Dental Practice, Pllc
NPI #1770150682 in Universal City, Texas
Provider Information
- NPI Number
- 1770150682
- Entity Type
- Organization
- Organization Name
- My Local Texas Dental Practice, Pllc
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- MY LOCAL TEXAS DENTAL PRACTICE, PLLC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Jun 9, 2021
- Last Updated
- Jun 9, 2021
Practice Location
- Address
- 1621 PAT BOOKER RD
- City
- Universal City
- State
- Texas
- ZIP Code
- 78148-3432
- Phone
- (210) 654-9094
Authorized Official
- Name
- MICHELLE JOHNSON
- Title
- CREDENTIALING SPECIALIST
- Phone
- (509) 315-8338
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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