Provider Demographics
NPI:1801147673
Name:DANIEL SEMUHA DDS P.C.
Entity type:Organization
Organization Name:DANIEL SEMUHA DDS P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SEMUHA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:210-545-1111
Mailing Address - Street 1:2846 THOUSAND OAKS DR.
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-6044
Mailing Address - Country:US
Mailing Address - Phone:210-545-1111
Mailing Address - Fax:
Practice Address - Street 1:2846 THOUSAND OAKS DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-4193
Practice Address - Country:US
Practice Address - Phone:818-430-1110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-20
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX271771223G0001X
TX249821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty