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Organization
CIBOLO 7TO7 PLLC
Active
Organization
CIBOLO 7TO7 PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA CAROLINA VILLARREAL (CREDENTIALING MANAGER)
(210) 495-2000
Entity
Organization
Contact information
Practice address
113 RODEO WAY STE 100, CIBOLO, TX 78108-3979
(210) 495-2000
(210) 495-2001
Mailing address
PO BOX 461649, SAN ANTONIO, TX 78246-1649
(210) 495-2000
(210) 495-2001
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
NULL
Other
Enumeration date
08/11/2021
Last updated
08/11/2021
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