Provider Demographics
NPI:1386809226
Name:CANTU-PETTY, BEATRIZ (DDS)
Entity type:Individual
Prefix:MISS
First Name:BEATRIZ
Middle Name:
Last Name:CANTU-PETTY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2358 E SOUTHCROSS BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78223-2263
Mailing Address - Country:US
Mailing Address - Phone:210-532-9998
Mailing Address - Fax:210-532-9992
Practice Address - Street 1:9262 CULEBRA RD
Practice Address - Street 2:107
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-3571
Practice Address - Country:US
Practice Address - Phone:210-680-0860
Practice Address - Fax:210-680-0861
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-21
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX193791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice