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Contact Information

MISSION PLAZA DENTAL PLLC
3454 ROOSEVELT AVE.
SAN ANTONIO, TX78214
 Phone: 210-546-1337
 Fax: 210-546-1348
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for MISSION PLAZA DENTAL PLLC

NPI Number 1104110501
LBN Legal business name MISSION PLAZA DENTAL PLLC
Authorized official ANDREW SCRAVER - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 06/02/2011
Last updated 06/02/2011 - About 15 years ago
Identifiers
TX License # 22951
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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