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Organization
XLNT DENTAL PLLC
Active
Organization
XLNT DENTAL PLLC
Active
Other names
Gravis & Riley Family Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIELA MARIE P PUNZALAN D.M.D. (OWNER/ GENERAL DENTIST)
(201) 970-9158
Entity
Organization
Contact information
Practice address
504 E GRAVIS ST, SAN DIEGO, TX 78384-2708
(201) 970-9158
Mailing address
3130 CANAVERAL DR, SAN ANTONIO, TX 78217-4007
(210) 970-9158
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30778
TX
Other
Enumeration date
03/07/2017
Last updated
03/07/2017
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