Individual
DR. ELLYSSE CANALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
323 NW 24TH ST, SAN ANTONIO, TX 78207-3209
(210) 436-6261
(210) 436-7126
Mailing address
323 NW 24TH ST, 323 NW 24TH STREET, SAN ANTONIO, TX 78207-3209
(210) 436-6261
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
25653
TX
1223G0001X
General Practice Dentistry
Primary
25653
TX
Other
Enumeration date
07/28/2010
Last updated
01/15/2014
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