Provider Demographics
NPI:1629191739
Name:LA JOYA DENTAL CENTER P.A.
Entity Type:Organization
Organization Name:LA JOYA DENTAL CENTER P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:LUIS
Authorized Official - Last Name:CAZARES
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:956-583-1011
Mailing Address - Street 1:PO BOX 5969
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78502-5969
Mailing Address - Country:US
Mailing Address - Phone:956-583-1011
Mailing Address - Fax:956-583-3501
Practice Address - Street 1:1312 EXPRESSWAY 83 SUITE B
Practice Address - Street 2:
Practice Address - City:PENITAS
Practice Address - State:TX
Practice Address - Zip Code:78576-2227
Practice Address - Country:US
Practice Address - Phone:956-583-1011
Practice Address - Fax:956-583-3501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty