Organization
CIBOLO PEDIATRIC DENTISTRY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOANNA AYALA (OWNER)
(210) 632-4560
Entity
Organization
Contact information
Practice address
3738 CIBOLO VALLEY DR., CIBOLO, TX 78108
(830) 772-4200
Mailing address
PO BOX 356, LYTLE, TX 78052-0356
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
05/31/2018
Last updated
09/14/2023
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