| Bradford Legacy Dental | |
|
4158 Swans Lndg San Antonio TX 78217-4239 | |
| (210) 655-4867 | |
| Not Available |
| Full Name | Bradford Legacy Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4158 Swans Lndg, San Antonio, Texas |
| Authorized Official Name and Position | Gwendolyn Calderon (SOLE MEMBER) |
| Authorized Official Contact | 2106554867 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bradford Legacy Dental 4158 Swans Lndg San Antonio TX 78217-4239 Ph: (210) 655-4867 | Bradford Legacy Dental 4158 Swans Lndg San Antonio TX 78217-4239 Ph: (210) 655-4867 |
| NPI Number | 1932864634 |
|---|---|
| Provider Enumeration Date | 11/08/2021 |
| Last Update Date | 11/08/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932864634 | NPI | - | NPPES |
| 1831602796 | Other | TX | NPI |
| 1396831681 | Other | TX | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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