Provider Demographics
NPI:1134511108
Name:HAPPY PEDIATRIC DENTISTRY, PC
Entity type:Organization
Organization Name:HAPPY PEDIATRIC DENTISTRY, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:210-410-5912
Mailing Address - Street 1:2602 N LOOP 1604 W
Mailing Address - Street 2:SUITE 207
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78248-1477
Mailing Address - Country:US
Mailing Address - Phone:210-510-2862
Mailing Address - Fax:210-802-4499
Practice Address - Street 1:2602 N LOOP 1604 W
Practice Address - Street 2:SUITE 207
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78248-1477
Practice Address - Country:US
Practice Address - Phone:210-510-2862
Practice Address - Fax:210-802-4499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-26
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX237051223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty