Organization
CRANIOMANDIBULAR ASSOCIATES OF SAN ANTONIO PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARA LEE CULLY (CEO)
(830) 446-5510
Entity
Organization
Contact information
Practice address
5 COUGHRAN RD STE 302, BOERNE, TX 78006-8103
(830) 446-5510
Mailing address
114 UPPER BALCONES RD, BOERNE, TX 78006-8545
(830) 446-5510
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/04/2025
Last updated
10/03/2025
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