Provider Demographics
NPI:1972878924
Name:ERNESTO TREVINO, DDS, PLLC
Entity Type:Organization
Organization Name:ERNESTO TREVINO, DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ENDODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ERNESTO
Authorized Official - Middle Name:GERARDO
Authorized Official - Last Name:TREVINO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:956-412-9500
Mailing Address - Street 1:1610 E HARRISON AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-7309
Mailing Address - Country:US
Mailing Address - Phone:956-412-9500
Mailing Address - Fax:
Practice Address - Street 1:1610 E HARRISON AVE STE A
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-7309
Practice Address - Country:US
Practice Address - Phone:956-412-9500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-08
Last Update Date:2012-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty