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Organization
MOLINA CLYDE DENTISTRY, PLLC
Active
Organization
MOLINA CLYDE DENTISTRY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IBIS VANESSA MOLINA-CLYDE (DDS)
(210) 749-8858
Entity
Organization
Contact information
Practice address
19298 STONE OAK PKWY, SUITE 1105, SAN ANTONIO, TX 78258-3393
(210) 749-8858
Mailing address
19298 STONE OAK PKWY, SUITE 1105, SAN ANTONIO, TX 78258-3393
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
11/04/2013
Last updated
11/04/2013
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