Provider Demographics
NPI:1841457165
Name:PREFERRED DENTAL P.C.
Entity type:Organization
Organization Name:PREFERRED DENTAL P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDRES
Authorized Official - Middle Name:E
Authorized Official - Last Name:BIAGGI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:210-822-8500
Mailing Address - Street 1:6850 SAN PEDRO AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-7201
Mailing Address - Country:US
Mailing Address - Phone:210-822-8500
Mailing Address - Fax:210-822-4999
Practice Address - Street 1:6850 SAN PEDRO AVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-7201
Practice Address - Country:US
Practice Address - Phone:210-822-8500
Practice Address - Fax:210-822-4999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX220481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1763930101Medicaid