Organization
LOST CREEK DENTAL TWO, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN TICE (OPERATIONS MANAGER)
(925) 852-3326
Entity
Organization
Contact information
Practice address
11919 CULEBRA RD BLDG 2, SAN ANTONIO, TX 78253-2102
(210) 688-0332
Mailing address
11919 CULEBRA RD BLDG 2, SAN ANTONIO, TX 78253-2102
(210) 688-0332
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
10/13/2025
Last updated
10/13/2025
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