Provider Demographics
NPI:1710158829
Name:CARLOS J. ROMERO D.D.S. AND ASSOCIATES P.L.L.C
Entity Type:Organization
Organization Name:CARLOS J. ROMERO D.D.S. AND ASSOCIATES P.L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:JAVIER
Authorized Official - Last Name:ROMERO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:956-723-1230
Mailing Address - Street 1:PO BOX 452286
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78045-0056
Mailing Address - Country:US
Mailing Address - Phone:956-723-1230
Mailing Address - Fax:
Practice Address - Street 1:4311 CLARK BLVD
Practice Address - Street 2:SUITE O
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78043-4129
Practice Address - Country:US
Practice Address - Phone:956-723-1230
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-17
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX214051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty