Organization
DEZAVALA DENTAL AND BRACES PLLC
Active
Other names
Dezavala Dental and Braces
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOEL OLMOS DDS (OWNER/ DOCTOR)
(512) 268-3384
Entity
Organization
Contact information
Practice address
4519 DEZAVALA ROAD, SAN ANTONIO, TX 78249
(210) 690-9221
Mailing address
4519 DEZAVALA ROAD, SAN ANTONIO, TX 78249
(210) 690-9221
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/08/2021
Last updated
11/16/2021
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