Mista Dental PLLC

Organization Active NPI General Practice Dentistry · Selma, TX

NPI 1558070953 · NPPES record last updated Jun 21, 2023

Key facts

NPI
1558070953
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
Legal business name
MISTA DENTAL PLLC
Practice address
8143 Agora Pkwy Ste 105
Selma, TX 78154-1357
Phone
(210) 659-6622
NPI assigned
Nov 15, 2022
Organization subpart
No

Authorized official

Name
Mangayarkarasi Mathiyazhagan
Title
Owner
Phone
(210) 659-6622

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
1223G0001X Yes

Addresses

Primary practice location

8143 Agora Pkwy Ste 105
Selma, TX 78154-1357

Mailing address

PO Box 70887
Cleveland, OH 44190-0887

Other providers in Selma, TX

All providers in Selma, TX · General Practice Dentistry in Texas

Sources for this page

Verify at the official NPI Registry.