Provider Demographics
NPI:1922013796
Name:MASTERS DENTAL GROUP, PC
Entity Type:Organization
Organization Name:MASTERS DENTAL GROUP, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WINSTON
Authorized Official - Middle Name:BRADLEY
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:210-349-4424
Mailing Address - Street 1:7400 BLANCO RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-4360
Mailing Address - Country:US
Mailing Address - Phone:210-349-4424
Mailing Address - Fax:
Practice Address - Street 1:7400 BLANCO RD
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-4360
Practice Address - Country:US
Practice Address - Phone:210-349-4424
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX168841223G0001X
TX168571223P0300X
TX156781223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Not Answered1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
Not Answered1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty