Individual
DR. TATYANA PUSTYLNIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
3551 ROGER BROOKE DR, SAN ANTONIO, TX 78234-4504
(210) 916-0332
Mailing address
3551 ROGER BROOKE DR, SAN ANTONIO, TX 78234-4504
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DN22232
FL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
40795
TX
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DN22232
FL
390200000X
Student in an Organized Health Care Education/Training Program
DN22232
FL
Other
Enumeration date
09/01/2016
Last updated
07/17/2024
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