Provider Demographics
NPI:1922710797
Name:SABAL DENTAL SAN ANTONIO PLLC
Entity Type:Organization
Organization Name:SABAL DENTAL SAN ANTONIO PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DRAKE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:956-428-3300
Mailing Address - Street 1:2319 E TYLER AVE
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-7384
Mailing Address - Country:US
Mailing Address - Phone:956-428-3300
Mailing Address - Fax:956-440-9207
Practice Address - Street 1:3740 COLONY DR STE 254
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-2233
Practice Address - Country:US
Practice Address - Phone:956-428-3300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-23
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty