| Street | 10120 Segovia Dr | ||
| City/Town | Waco | ||
| State/Province/Region | Texas | ||
| Zip/Postal Code | 76708 | ||
| Phone Number | (254) 715-5613 | ||
| Country | United States |
| Full Name | Prof. Arvid Ullrich DDS | ||
| Gender | male | ||
| Birthday | 1988-03-01 | ||
| Social Security Number | 026-92-2723 |
| Credit card brand | American Express | ||
| Credit card number | 347174806951617 | ||
| Expire | 2031/12 | ||
| CVV | 146 |