Individual
GABRIELLA DANIELLE DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS, MSD
Contact information
Practice address
5419 FREDERICKSBURG RD, SAN ANTONIO, TX 78229-3503
(210) 616-0980
Mailing address
11215 ANAQUA SPGS, BOERNE, TX 78006-8493
(817) 300-6658
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
35975
TX
Other
Enumeration date
04/06/2021
Last updated
12/07/2022
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