Organization
KERRVILLE PEDIATRIC DENTISTRY, PLLC
Active
Other names
Tots to Teens Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
JOANNA AYALA D.M.D. (MANAGING MEMBER)
(210) 632-4560
Entity
Organization
Contact information
Practice address
1700 SIDNEY BAKER ST, SUITE #200, KERRVILLE, TX 78028-2654
(210) 632-4560
Mailing address
12016 EUCALYPTUS ST, SAN ANTONIO, TX 78245-3307
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
24255
TX
Other
Enumeration date
11/06/2014
Last updated
11/06/2014
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