Provider Demographics
NPI:1326340985
Name:BADEA, LUANA G (DDS)
Entity Type:Individual
Prefix:
First Name:LUANA
Middle Name:G
Last Name:BADEA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 NW 24TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78207
Mailing Address - Country:US
Mailing Address - Phone:210-567-3456
Mailing Address - Fax:210-567-3443
Practice Address - Street 1:323 NW 24TH ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78207
Practice Address - Country:US
Practice Address - Phone:210-436-6261
Practice Address - Fax:210-436-7126
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-02
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXUTSA929-X1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice