Provider Demographics
NPI:1356787766
Name:SOUTH TEXAS DENTISTRY, PLLC
Entity type:Organization
Organization Name:SOUTH TEXAS DENTISTRY, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAMIEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:956-661-1000
Mailing Address - Street 1:800 E DOVE AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-2262
Mailing Address - Country:US
Mailing Address - Phone:956-661-1000
Mailing Address - Fax:
Practice Address - Street 1:800 E DOVE AVE
Practice Address - Street 2:SUITE C
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-2262
Practice Address - Country:US
Practice Address - Phone:956-661-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-13
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental