Provider Demographics
NPI:1861979239
Name:SABAL DENTAL ROCKDALE PLLC
Entity type:Organization
Organization Name:SABAL DENTAL ROCKDALE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DRAKE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:956-245-2766
Mailing Address - Street 1:2319 E TYLER AVE
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-7384
Mailing Address - Country:US
Mailing Address - Phone:956-428-3300
Mailing Address - Fax:
Practice Address - Street 1:307 CHILDRESS DR
Practice Address - Street 2:
Practice Address - City:ROCKDALE
Practice Address - State:TX
Practice Address - Zip Code:76567-2729
Practice Address - Country:US
Practice Address - Phone:512-446-5886
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-27
Last Update Date:2018-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty