Provider Demographics
NPI:1386142768
Name:BULVERDE POINT DENTAL, PLLC
Entity type:Organization
Organization Name:BULVERDE POINT DENTAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:CHAFIC
Authorized Official - Last Name:MAJDALANI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:210-251-1589
Mailing Address - Street 1:5507 HORIZON DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78228-1822
Mailing Address - Country:US
Mailing Address - Phone:210-251-1589
Mailing Address - Fax:
Practice Address - Street 1:30745 N HWY 281
Practice Address - Street 2:SUITE 103
Practice Address - City:BULVERDE
Practice Address - State:TX
Practice Address - Zip Code:78163
Practice Address - Country:US
Practice Address - Phone:210-251-1589
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-31
Last Update Date:2018-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX318991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty