Organization
CIBOLO DENTER CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA ENRIQUEZ (DENTIST)
(210) 658-7200
Entity
Organization
Contact information
Practice address
3893 CIBOLO VALLEY DR, 104, CIBOLO, TX 78108
(210) 658-7200
(210) 658-7206
Mailing address
3893 CIBOLO VALLEY DR, 104, CIBOLO, TX 78108
(210) 658-7200
(210) 658-7206
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
124Q00000X
Dental Hygienist
—
—
126800000X
Dental Assistant
—
—
Other
Enumeration date
04/11/2013
Last updated
04/11/2013
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