Provider Demographics
NPI:1972991735
Name:OAKWELL DENTAL CARE
Entity type:Organization
Organization Name:OAKWELL DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:DYLAN
Authorized Official - Last Name:CAREY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:210-832-9993
Mailing Address - Street 1:3301 OAKWELL CT ST 102
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78218
Mailing Address - Country:US
Mailing Address - Phone:210-832-9993
Mailing Address - Fax:
Practice Address - Street 1:3301 OAKWELL CT ST 102
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78218-3074
Practice Address - Country:US
Practice Address - Phone:210-832-9993
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-02
Last Update Date:2015-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX271531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1164574786OtherNPI- OAKWELL DENTAL OLD
TX1104978725OtherNPI- SUSAN RAQUET
TX1841324266OtherNPI- DAVID SINGLETON
TX1710039334OtherNPI- GREG OSBORNE
TX1871881730OtherNPI- DYLAN CAREY