Provider Demographics
NPI:1649814294
Name:DENTAL ORAL CARE, PLLC
Entity type:Organization
Organization Name:DENTAL ORAL CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:HANNA
Authorized Official - Suffix:
Authorized Official - Credentials:BDS, DDS, MACSD
Authorized Official - Phone:210-687-1444
Mailing Address - Street 1:23535 W INTERSTATE 10 STE 2202
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78257-1673
Mailing Address - Country:US
Mailing Address - Phone:210-687-1444
Mailing Address - Fax:
Practice Address - Street 1:23535 W INTERSTATE 10 STE 2202
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78257-1673
Practice Address - Country:US
Practice Address - Phone:210-687-1444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-06
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental