Provider Demographics
NPI:1932521994
Name:TOEPPERRICAN OROFACIAL PLLC
Entity Type:Organization
Organization Name:TOEPPERRICAN OROFACIAL PLLC
Other - Org Name:TOEPPERWEIN ORAL AND FACIAL SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER CO-PRINCIPAL
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:V
Authorized Official - Last Name:MALAVE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:210-202-0406
Mailing Address - Street 1:11515 TOEPPERWEIN RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LIVE OAK
Mailing Address - State:TX
Mailing Address - Zip Code:78233-3151
Mailing Address - Country:US
Mailing Address - Phone:210-202-0406
Mailing Address - Fax:
Practice Address - Street 1:11515 TOEPPERWEIN RD
Practice Address - Street 2:SUITE 100
Practice Address - City:LIVE OAK
Practice Address - State:TX
Practice Address - Zip Code:78233-3151
Practice Address - Country:US
Practice Address - Phone:210-202-0406
Practice Address - Fax:210-978-5505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-10
Last Update Date:2014-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty