Organization
CITY BASE PEDIATRIC DENTISTRY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOANNA AYALA DMD (OWNER)
(830) 772-5600
Entity
Organization
Contact information
Practice address
2302 SE MILITARY DR STE 101, SAN ANTONIO, TX 78223-3586
(830) 772-5600
Mailing address
PO BOX 356, LYTLE, TX 78052-0356
(956) 725-3100
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
11/24/2020
Last updated
11/24/2020
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