Organization
COSMETIC DENTISTRY OF SAN ANTONIO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ASHLEY J GONZALEZ (ADMINISTRATIVE ASSISTANT)
(210) 493-9944
Entity
Organization
Contact information
Practice address
16535 HUEBNER RD STE 102, SAN ANTONIO, TX 78248-1676
(210) 493-9944
(210) 493-9946
Mailing address
16535 HUEBNER RD STE 102, SAN ANTONIO, TX 78248-1676
(210) 493-9944
(210) 493-9946
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223D0001X
Public Health Dentistry
—
—
Other
Enumeration date
06/22/2017
Last updated
07/21/2022
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