Provider Demographics
NPI:1518193614
Name:SILVER OAKS DENTISTRY
Entity Type:Organization
Organization Name:SILVER OAKS DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMANUEL
Authorized Official - Middle Name:F
Authorized Official - Last Name:DEHELEAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:210-656-4699
Mailing Address - Street 1:4719 CAMINO DORADO DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78233-6302
Mailing Address - Country:US
Mailing Address - Phone:210-656-4699
Mailing Address - Fax:210-277-8517
Practice Address - Street 1:4717 CAMINO DORADO DRIVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78233
Practice Address - Country:US
Practice Address - Phone:210-656-4699
Practice Address - Fax:210-277-8517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-03
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22549261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental