institution
Shiva Izaddoust D.d.s. P.a.
Dental Clinic/Center in San Antonio, Texas
NPI 1275667503

Shiva Izaddoust D.d.s. P.a. is a Dental Clinic/Center based in San Antonio, TX and is specialized in Dental. Shiva Izaddoust D.d.s. P.a. practices in San Antonio, TX. The NPI Number for Shiva Izaddoust D.d.s. P.a. is 1275667503 and holds a License No. (Texas).

The current practice location address for Shiva Izaddoust D.d.s. P.a. is 700 S Zarzamora St, San Antonio, TX and can be reached out via phone at 210-432-0298 and via fax at 210-432-6044.

Location: 700 S Zarzamora St, San Antonio, TX, 78207-5255
institution
Provider Profile Details
NPI Number
1275667503
Provider Name
Shiva Izaddoust D.d.s. P.a.
Credential
Provider Entity Type
Organization
Address
700 S Zarzamora St, San Antonio, TX, 78207-5255
Phone Number
210-432-0298
Fax Number
210-432-6044
Provider Enumeration Date
03/16/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
7028 01 TX BLUE CROSS BLUE SHIELD
G60126-02 01 TX TEXAS CHIP
1300534 01 TX UNITED CONCORDIA
institution
Provider Business Practice Location Address Details
Address
700 S Zarzamora St
City
State
Zip
78207-5255
Phone Number
210-432-0298
Fax Number
210-432-6044
person
Provider Business Mailing Address Details
Address
700 S Zarzamora St
City
State
Zip
78207-5255
Phone Number
210-432-0298
Fax Number
210-432-6044
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Dental
Taxonomy
License No.
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Definition
Definition to come...
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