Provider Demographics
NPI:1114311875
Name:WESLACO FAMILY DENTISTRY PLLC
Entity type:Organization
Organization Name:WESLACO FAMILY DENTISTRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARISOL
Authorized Official - Middle Name:
Authorized Official - Last Name:ALANIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-428-5322
Mailing Address - Street 1:2307 W. EXP.
Mailing Address - Street 2:SUITE C
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596
Mailing Address - Country:US
Mailing Address - Phone:956-428-5322
Mailing Address - Fax:956-428-7986
Practice Address - Street 1:1214 DIXIELAND RD
Practice Address - Street 2:SUITE # 4
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78552-3351
Practice Address - Country:US
Practice Address - Phone:956-428-5322
Practice Address - Fax:956-428-7986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-20
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty