Provider Demographics
NPI:1437906708
Name:JM DENTAL SERVICES, PLLC
Entity type:Organization
Organization Name:JM DENTAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:MIJARES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:210-909-5502
Mailing Address - Street 1:4115 POND HILL RD STE 102
Mailing Address - Street 2:
Mailing Address - City:SHAVANO PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78231-1285
Mailing Address - Country:US
Mailing Address - Phone:210-788-1967
Mailing Address - Fax:
Practice Address - Street 1:4115 POND HILL RD STE 102
Practice Address - Street 2:
Practice Address - City:SHAVANO PARK
Practice Address - State:TX
Practice Address - Zip Code:78231-1285
Practice Address - Country:US
Practice Address - Phone:210-788-1967
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-03
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty