Provider Demographics
NPI:1538280771
Name:TREVINO, OSCAR GUILLERMO (DDS)
Entity Type:Individual
Prefix:DR
First Name:OSCAR
Middle Name:GUILLERMO
Last Name:TREVINO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8940 CULEBRA RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-2812
Mailing Address - Country:US
Mailing Address - Phone:210-684-1313
Mailing Address - Fax:210-521-2563
Practice Address - Street 1:8940 CULEBRA RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-2812
Practice Address - Country:US
Practice Address - Phone:210-684-1313
Practice Address - Fax:210-521-2563
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX129141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice