Provider Demographics
NPI:1467746784
Name:IRMA CANTU-THOMPSON DDSPC
Entity Type:Organization
Organization Name:IRMA CANTU-THOMPSON DDSPC
Other - Org Name:SMILES-R-US
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:IRMA
Authorized Official - Middle Name:
Authorized Official - Last Name:CANTU-THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:210-923-5422
Mailing Address - Street 1:1114 SW MILITARY DR
Mailing Address - Street 2:SUITE #112
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78221-1568
Mailing Address - Country:US
Mailing Address - Phone:210-923-5422
Mailing Address - Fax:210-923-2974
Practice Address - Street 1:1114 SW MILITARY DR
Practice Address - Street 2:SUITE #112
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78221-1568
Practice Address - Country:US
Practice Address - Phone:210-923-5422
Practice Address - Fax:210-923-2974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-03
Last Update Date:2011-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX009377501Medicaid