Organization
TOTS TO TEENS ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOANNA AYALA (MANAGING MEMBER)
(210) 632-4560
Entity
Organization
Contact information
Practice address
9902 MCPHERSON RD STE 25, LAREDO, TX 78045-6546
(956) 725-3100
Mailing address
PO BOX 356, LYTLE, TX 78052-0356
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
24255
TX
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
24255
TX
Other
Enumeration date
12/30/2013
Last updated
12/30/2013
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