Provider Demographics
NPI:1225359979
Name:ACCESS ORTHODONTICS OF PLEASANTON, P.A.
Entity Type:Organization
Organization Name:ACCESS ORTHODONTICS OF PLEASANTON, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANURAG
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:210-923-2724
Mailing Address - Street 1:803 SW MILITARY DR
Mailing Address - Street 2:SUITE #130
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78221-1528
Mailing Address - Country:US
Mailing Address - Phone:210-923-2724
Mailing Address - Fax:
Practice Address - Street 1:803 SW MILITARY DR
Practice Address - Street 2:SUITE #130
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78221-1528
Practice Address - Country:US
Practice Address - Phone:210-923-2724
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-17
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX232181223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty