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Organization

LYTLE PEDIATRIC DENTISTRY, PLLC

Active
Other names
Tots to Teens Pediatric Dentistry
Organization subpart
No

Provider details

NPI number
Authorized official
JOANNA AYALA (PRESIDENT/OWNER)
(210) 632-4560
Entity
Organization

Contact information

Practice address
19315 MCDONALD ST, LYTLE, TX 78052-3622
(830) 772-5600
Mailing address
PO BOX 356, LYTLE, TX 78052

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
24255
TX

Other

Enumeration date
10/01/2013
Last updated
02/08/2016
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