De la Rosa and Martinez Dentistry PLLC

Organization Active NPI General Practice Dentistry · San Benito, TX

NPI 1831550185 · NPPES record last updated Mar 15, 2016

Key facts

NPI
1831550185
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
Legal business name
DE LA ROSA AND MARTINEZ DENTISTRY PLLC
Practice address
985 S Sam Houston Blvd
San Benito, TX 78586-3064
Phone
(956) 399-4312
Fax
(956) 399-9337
NPI assigned
Mar 15, 2016
Organization subpart
No

Authorized official

Name
Mrs. Patricia De la Rosa
Title
Office Manager
Phone
(956) 399-4312

National Provider Directory

Locations

985 S Sam Houston Blvd
San Benito, TX 78586
Phone (956) 399-4312

Specialties & licenses

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

Addresses

Primary practice location

985 S Sam Houston Blvd
San Benito, TX 78586-3064

Mailing address

985 S Sam Houston Blvd
San Benito, TX 78586-3064
Phone (956) 399-4312

Other identifiers

IdentifierTypeStateIssuer
111234402MedicaidTX
198199501MedicaidTX
213449601MedicaidTX
335402901MedicaidTX

Other providers in San Benito, TX

All providers in San Benito, TX · General Practice Dentistry in Texas

Sources for this page

Verify at the official NPI Registry.