Organization
ALTA VISTA DENTISTRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARISSA MOONEY (PRACTICE MANAGER)
(210) 734-6556
Entity
Organization
Contact information
Practice address
405 W GRAMERCY PL, SAN ANTONIO, TX 78212-2827
(210) 734-6556
Mailing address
405 W GRAMERCY PL, SAN ANTONIO, TX 78212-2827
(210) 734-6556
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
11/20/2024
Last updated
11/20/2024
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