Provider Demographics
NPI:1114532884
Name:SAFARI CHILDRENS DENTISTRY & BRACES PLLC
Entity Type:Organization
Organization Name:SAFARI CHILDRENS DENTISTRY & BRACES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:210-872-4075
Mailing Address - Street 1:13032 NACOGDOCHES RD STE 202
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-1962
Mailing Address - Country:US
Mailing Address - Phone:210-404-7228
Mailing Address - Fax:
Practice Address - Street 1:13032 NACOGDOCHES RD STE 202
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-1962
Practice Address - Country:US
Practice Address - Phone:210-404-7228
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-10
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty