| San Marcos Dental and Braces PLLC | |
|
102 Wonder World Dr Ste 101 San Marcos TX 78666-6080 | |
| (210) 944-0504 | |
| Not Available |
| Full Name | San Marcos Dental and Braces PLLC |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 102 Wonder World Dr Ste 101, San Marcos, Texas |
| Authorized Official Name and Position | Rosa Wolfford (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 2105689800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| San Marcos Dental and Braces PLLC Po Box 849 Jasper TX 75951-0010 | San Marcos Dental and Braces PLLC 102 Wonder World Dr Ste 101 San Marcos TX 78666-6080 Ph: (210) 944-0504 |
| NPI Number | 1336912864 |
|---|---|
| Provider Enumeration Date | 11/06/2023 |
| Last Update Date | 11/13/2023 |
| Certification Date | 11/13/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336912864 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | () | Secondary |
| 261QD0000X | Clinic/center - Dental | () | Primary |
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