Provider Demographics
NPI:1447372438
Name:SATTEM, LISA OLIVEIRA (DDS)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:OLIVEIRA
Last Name:SATTEM
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 1:13626 SONORA BLF
Mailing Address - Street 2:
Mailing Address - City:HELOTES
Mailing Address - State:TX
Mailing Address - Zip Code:78023-3639
Mailing Address - Country:US
Mailing Address - Phone:210-695-6609
Mailing Address - Fax:
Practice Address - Street 1:7959 BROADWAY ST
Practice Address - Street 2:SUITE 506
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-2667
Practice Address - Country:US
Practice Address - Phone:210-824-9272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX198001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice