Provider Demographics
NPI:1700049806
Name:AWAGU, SYLVESTER C (DMD)
Entity Type:Individual
Prefix:DR
First Name:SYLVESTER
Middle Name:C
Last Name:AWAGU
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5500 WALZEM RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78218-2103
Mailing Address - Country:US
Mailing Address - Phone:210-657-4641
Mailing Address - Fax:210-655-2012
Practice Address - Street 1:5500 WALZEM RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78218-2103
Practice Address - Country:US
Practice Address - Phone:215-888-6788
Practice Address - Fax:210-655-4012
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX242091223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry