Provider Demographics
NPI:1144599531
Name:CELE POKORNEY DDS PLLC
Entity Type:Organization
Organization Name:CELE POKORNEY DDS PLLC
Other - Org Name:OLIVER FAMILY ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CELESTE
Authorized Official - Middle Name:
Authorized Official - Last Name:OLIVER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, DHSC
Authorized Official - Phone:2105-491-0111
Mailing Address - Street 1:10865 SHAENFIELD RD
Mailing Address - Street 2:SUITE #1111
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78254-9601
Mailing Address - Country:US
Mailing Address - Phone:210-549-1011
Mailing Address - Fax:
Practice Address - Street 1:10865 SHAENFIELD RD
Practice Address - Street 2:SUITE #1111
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78254-9601
Practice Address - Country:US
Practice Address - Phone:210-549-1011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CELE POKORNEY DDS PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-12-14
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX253121223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty