| Texas Dental Specialist Practice, Pllc | |
|
20540 Highway 46 W Ste 100 Spring Branch TX 78070-6825 | |
| (830) 980-8099 | |
| Not Available |
| Full Name | Texas Dental Specialist Practice, Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 20540 Highway 46 W Ste 100, Spring Branch, Texas |
| Authorized Official Name and Position | Gregory Kostelac (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 7193725605 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Texas Dental Specialist Practice, Pllc 6110 Barnes Rd Colorado Springs CO 80922-2600 Ph: () - | Texas Dental Specialist Practice, Pllc 20540 Highway 46 W Ste 100 Spring Branch TX 78070-6825 Ph: (830) 980-8099 |
| NPI Number | 1770243693 |
|---|---|
| Provider Enumeration Date | 12/20/2021 |
| Last Update Date | 07/26/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770243693 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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