# KLT DENTISTRY PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Kaci L. Tibbetts
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093068744
- **Authorized official:** KACI TIBBETTS DDS (OWNER)
- **Authorized official phone:** (210) 496-5422

## Contact information

- **Practice address:** 3223 THOUSAND OAKS DR, STE \#102, SAN ANTONIO, TX 78247
- **Practice address phone:** (210) 496-5422
- **Practice address fax:** (210) 490-2388
- **Mailing address:** 3223 THOUSAND OAKS DR, STE \#102, SAN ANTONIO, TX 78247
- **Mailing address phone:** (210) 496-5422
- **Mailing address fax:** (210) 490-2388

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 12844 | TX | — |
| 122300000X | Dentist | 26455 | TX | Yes |

## Other

- **Enumeration date:** 10/18/2012
- **Last updated:** 06/22/2018