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Organization
DEZAVALA DENTAL AND BRACES PLLC
Active
Organization
DEZAVALA DENTAL AND BRACES PLLC
Active
Other names
Dezavala Dental and Braces
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOEL OLMOS DDS (OWNER/ DOCTOR)
(512) 268-3384
Entity
Organization
Contact information
Practice address
4519 DEZAVALA ROAD, SAN ANTONIO, TX 78249
(210) 690-9221
Mailing address
4519 DEZAVALA ROAD, SAN ANTONIO, TX 78249
(210) 690-9221
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/08/2021
Last updated
11/16/2021
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