Provider Demographics
NPI:1073589131
Name:DEHELEAN, EMANUEL FLORIAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:EMANUEL
Middle Name:FLORIAN
Last Name:DEHELEAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4719 CAMINO DORADO DR
Mailing Address - Street 2:STE 2
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78233-6357
Mailing Address - Country:US
Mailing Address - Phone:210-656-4699
Mailing Address - Fax:210-656-4699
Practice Address - Street 1:MASON DENTAL CENTER
Practice Address - Street 2:4455 HARRY WURZBACH
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209
Practice Address - Country:US
Practice Address - Phone:210-822-4664
Practice Address - Fax:210-822-4878
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2016-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0022549122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice