Provider Demographics
NPI:1871875997
Name:MCPHERSON DENTAL CENTER
Entity type:Organization
Organization Name:MCPHERSON DENTAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUERRA ZUNIGA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:956-717-8899
Mailing Address - Street 1:6019 MCPHERSON RD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-6178
Mailing Address - Country:US
Mailing Address - Phone:956-717-8899
Mailing Address - Fax:
Practice Address - Street 1:6019 MCPHERSON RD
Practice Address - Street 2:SUITE 5
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-6178
Practice Address - Country:US
Practice Address - Phone:956-717-8899
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-14
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16711122300000X
TX17103124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No124Q00000XDental ProvidersDental HygienistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1730382011OtherNPPES