# DEZAVALA DENTAL AND BRACES PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Dezavala Dental and Braces
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194494708
- **Authorized official:** DR. JOEL OLMOS DDS (OWNER/ DOCTOR)
- **Authorized official phone:** (512) 268-3384

## Contact information

- **Practice address:** 4519 DEZAVALA ROAD, SAN ANTONIO, TX 78249
- **Practice address phone:** (210) 690-9221
- **Mailing address:** 4519 DEZAVALA ROAD, SAN ANTONIO, TX 78249
- **Mailing address phone:** (210) 690-9221

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 09/08/2021
- **Last updated:** 11/16/2021