Organization
LA TOOTH DOC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY WALTERS-BADILLO DMD (OWNER, DMD)
(859) 492-7565
Entity
Organization
Contact information
Practice address
12951 HUEBNER RD UNIT 780982, SAN ANTONIO, TX 78278-7837
(859) 492-7565
Mailing address
12951 HUEBNER RD UNIT 780982, SAN ANTONIO, TX 78278-7837
(859) 492-7565
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
12/04/2025
Last updated
12/04/2025
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