KUSOM PEDIATRIC DENTAL SOUTH PLLC NPI 1669011235

NPI Information

KUSOM PEDIATRIC DENTAL SOUTH PLLC is a pediatric dentistry dentist in San Antonio, TX. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. KUSOM PEDIATRIC DENTAL SOUTH PLLC NPI is 1669011235. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Great Kids Dental.

The provider's business location address is:

1134 CULEBRA RD STE 109
SAN ANTONIO, TX
ZIP 78201-080
Phone: (210) 888-0700
Fax: (210) 625-7398

The provider's authorized official is Oshmi Dutta .
The authorized official title is Ceo and has the following contact phone number (210) 888-0700.

The enumeration date for this NPI number is 12/31/2019 and was last updated on 10/13/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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