Provider Demographics
NPI:1891238085
Name:GPS DENTAL, PLLC
Entity type:Organization
Organization Name:GPS DENTAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GENEVIEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:SKROBANEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-633-3477
Mailing Address - Street 1:3151 SE MILITARY DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78223-3985
Mailing Address - Country:US
Mailing Address - Phone:210-633-3477
Mailing Address - Fax:210-633-3480
Practice Address - Street 1:3151 SE MILITARY DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78223-3985
Practice Address - Country:US
Practice Address - Phone:210-633-3477
Practice Address - Fax:210-633-3480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-21
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17642332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies