Provider Demographics
NPI:1740626464
Name:OAK HOLLOW DENTAL, PLLC
Entity type:Organization
Organization Name:OAK HOLLOW DENTAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBYN
Authorized Official - Middle Name:KATHLENE
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:210-314-6635
Mailing Address - Street 1:2250 THOUSAND OAKS DR
Mailing Address - Street 2:SUITE 120
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-3989
Mailing Address - Country:US
Mailing Address - Phone:210-314-6635
Mailing Address - Fax:210-314-6703
Practice Address - Street 1:2250 THOUSAND OAKS DR
Practice Address - Street 2:SUITE 120
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-3989
Practice Address - Country:US
Practice Address - Phone:210-314-6635
Practice Address - Fax:210-314-6703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-21
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX271021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty