Provider Demographics
NPI:1669695821
Name:STEPHEN F. WOOD, D.D.S., PA
Entity type:Organization
Organization Name:STEPHEN F. WOOD, D.D.S., PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CORINNE
Authorized Official - Middle Name:R
Authorized Official - Last Name:PIERCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-558-3133
Mailing Address - Street 1:4402 VANCE JACKSON RD
Mailing Address - Street 2:SUITE 235
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-5336
Mailing Address - Country:US
Mailing Address - Phone:210-558-3133
Mailing Address - Fax:210-308-9062
Practice Address - Street 1:4402 VANCE JACKSON RD
Practice Address - Street 2:SUITE 235
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-5336
Practice Address - Country:US
Practice Address - Phone:210-558-3133
Practice Address - Fax:210-308-9062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX125241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty