# ELLYSSE CANALES DDS PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** 24th Street Dental Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801229885
- **Authorized official:** DR. ELLYSSE YVETTE CANALES DDS (DENTIST)
- **Authorized official phone:** (210) 436-6261

## Contact information

- **Practice address:** 323 NW 24TH ST, SAN ANTONIO, TX 78207-3209
- **Practice address phone:** (210) 436-6261
- **Mailing address:** 323 NW 24TH ST, SAN ANTONIO, TX 78207-3209
- **Mailing address phone:** (210) 436-6261

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 25653 | TX | Yes |

## Other

- **Enumeration date:** 08/14/2013
- **Last updated:** 08/14/2013