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Organization

CULEBRA PEDIATRIC DENTISTRY, PLLC

Active
Other names
Tots to Teens Pediatric Dentistry
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOANNA AYALA D.M.D. (PRESIDENT)
(210) 632-4560
Entity
Organization

Contact information

Practice address
8839 CULEBRA ROAD, SUITE #105, SAN ANTONIO, TX 78251
(210) 660-7123
Mailing address
PO BOX 356, LYTLE, TX 78052-0356

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
1223P0221X
Pediatric Dentistry
Primary
24255
TX

Other

Enumeration date
09/29/2014
Last updated
09/29/2014
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